NPIMap

Organization Active NPI

Avatar Residential Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Cranston, RI
National Provider Identifier
1376660043
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
254 Issued in RI
Legal business name
AVATAR RESIDENTIAL INC.
Practice address
15 Lillian LN
Cranston, RI 02920-6200
Phone
(401) 942-0720
NPI assigned
Mar 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kathleen A. Ellis
Title
Vice President
Phone
(401) 826-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 254 RI Primary

Addresses

Primary practice location

15 Lillian LN
Cranston, RI 02920-6200

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
AA25880OtherRIPROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Avatar Residential Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376660043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 COLLEGE HILL RD",
            "address_2": "BUILDING 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": "15 LILLIAN LN",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206200",
            "telephone_number": "401-942-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVATAR RESIDENTIAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "401-826-7500"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "RI",
            "license": "254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "AA25880",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.