OrganizationActive
100 Wampanoag Trail Operating Company, LLC
NPI 1093057143 · Skilled Nursing Facility · Riverside, RI
Provider details
- NPI number
- 1093057143
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Authorized official
- Jeffrey Rubin, Co-Chief Executive Officer
Practice location
100 Wampanoag Trl
Riverside, RI 02915-3736
Phone: (401) 438-4275
Fax: (401) 438-8093
Mailing address
500 Seneca St Ste 100
Buffalo, NY 14204-1963
Registry dates
- Enumerated
- 2013-03-26
- Last updated
- 2023-01-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.