642 Metacom Avenue Operations LLC
NPI 1265683874ActiveOrganization· Skilled Nursing Facility· Warren, RI
Skilled Nursing Facility in Warren, Rhode Island, registered in NPPES in October 2008. The authorized official on file is Michael T. Berg, Assistant Secretary.
Overview
| NPI | 1265683874 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 2, 2008 |
| Last updated in NPPES | Jan 22, 2024 |
| Certified by provider | Jan 22, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | LTC00733 | RI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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