Provider First Line Business Practice Location Address:
1959 KINGSTOWN ROAD
Provider Second Line Business Practice Location Address:
SOUTH BAY RETIREMENT LIVING
Provider Business Practice Location Address City Name:
SOUTH KINGSTOWN
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02879-1608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-789-5880
Provider Business Practice Location Address Fax Number:
401-783-2880
Provider Enumeration Date:
08/08/2008