Provider First Line Business Practice Location Address:
12 OLD POCASSET LANE
Provider Second Line Business Practice Location Address:
POCASSET RETIREMENT LIVING
Provider Business Practice Location Address City Name:
JOHNSTON
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-421-6610
Provider Business Practice Location Address Fax Number:
401-421-0074
Provider Enumeration Date:
03/12/2007