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41D0658497 CLIA NUMBER - HATTIE IDE CHAFFEE NURSING HOME

Laboratory Demographics

CLIA Number: 41D0658497

Facility Name: HATTIE IDE CHAFFEE NURSING HOME

Facility Address:
200 WAMPANOAG TRAIL
EAST PROVIDENCE, RI
ZIP 02915
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Facility Phone Number: 401 434-1520

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1700912458

Taxonomy: 314000000X - Skilled Nursing Facility
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

CLIA Record

Field Name Field Value
CLIA Number 41D0658497
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HATTIE IDE CHAFFEE NURSING HOME
Street 200 WAMPANOAG TRAIL
City EAST PROVIDENCE
State RI
ZIP 02915
Phone 401 434-1520
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024