SRC East Side, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SRC EAST SIDE, LLC

Practice address

1 Butler Ave
Providence, RI 02906-5119

Phone

(401) 275-0682

NPI assigned

Nov 20, 2015

Organization subpart

No

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

Authorized official

Name

Tamilyn Levin

Title

Chief Financial Officer

Phone

(781) 707-9510

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1427422906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 KENDRICK ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BUTLER AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065119",
            "telephone_number": "401-275-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRC EAST SIDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "LEVIN",
        "authorized_official_first_name": "TAMILYN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "781-707-9510"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Springwater, M.A.
• Philippa Gabrielle Sprinz, MD
• Emily Borman Spurrell, PHD
• Annarose Squillante, LMHC
• SRC Blackstone Op, LLC
• SRC Providence, LLC
• SRC Providence, LLC
• Aradhana Srinagesh
• St Joseph Health Services of Rhode Island
• Kathleen St Lawrence, RN, BSN

• Assisted Living Facility in Providence, RI
• Providers in Providence, RI by specialty
• Assisted Living Facility in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.