NPIMap

Organization Active NPI

Avatar Residential, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Warwick, RI
National Provider Identifier
1053607754
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
136 Issued in RI
Legal business name
AVATAR RESIDENTIAL, INC.
Practice address
33 College Hill Rd
BLDG.33
Warwick, RI 02886-2776
Phone
(401) 826-7500
Fax
(401) 826-7503
NPI assigned
Jun 22, 2011
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kathleen A Ellis
Title
Executive Director
Phone
(401) 826-7500

Corporate family (same tax ID) 10

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
Avatar Residential Inc (11 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 136 RI Primary

Addresses

NPPES NPI Registry

Primary practice location

33 College Hill Rd
BLDG.33
Warwick, RI 02886-2776

Mailing address

33 College Hill Rd
BLDG.33
Warwick, RI 02886-2776
Phone (401) 826-7500

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
AI54946OtherRIPROVIDER NUMBER

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 22, 2011.

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1053607754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 COLLEGE HILL RD",
            "address_2": "BLDG.33",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862776",
            "telephone_number": "401-826-7500",
            "fax_number": "401-826-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 COLLEGE HILL RD",
            "address_2": "BLDG.33",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862776",
            "telephone_number": "401-826-7500",
            "fax_number": "401-826-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVATAR RESIDENTIAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "401-826-7500"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "RI",
            "license": "136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "AI54946",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.