Avalon Nursing Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

N446 Issued in RI

Legal business name

AVALON NURSING HOME INC

Doing business as

Avalon Nursing Home

Practice address

57 Stokes St
Warwick, RI 02889-3425

Phone

(401) 738-1200

Fax

(401) 738-9430

NPI assigned

Nov 9, 2005

Last updated

Jan 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David Stephen Kowalik

Title

Assistant Administrator

Phone

(401) 738-1200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Avalon Nursing Home Doing business as

Medicare fee-for-service enrollment

Enrolled in RI2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891776522. Details of each certification follow.

• CCN 415060 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 415060

Legal name

AVALON NURSING HOME, INC.

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 1, 1980

Last certification

May 30, 2025

Beds

31

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

Jan 1, 1964 in RI

Enrollment address

57 Stokes St
Warwick, RI 02889-3425

Nursing home name

AVALON NURSING HOME INC

Listed as

Avalon Nursing Home INCCCN 415060 · All quality measures

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Feb 1, 1980

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

3129.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Ralph F Santoro, M.D.

  • Internal Medicine Physician
  • Cranston, RI
  • NPI 1710098249

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hao Yuan Huang, M.D.

  • Internal Medicine Physician
  • Cranston, RI
  • NPI 1902826316
  Medicare reassignment NPD

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1891776522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 STOKES ST",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028893425",
            "telephone_number": "401-738-1200",
            "fax_number": "401-738-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 STOKES ST",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028893425",
            "telephone_number": "401-738-1200",
            "fax_number": "401-738-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "KOWALIK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "401-738-1200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "RI",
            "license": "N446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4105060",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Warwick, RI
• Providers in Warwick, RI by specialty
• Skilled Nursing Facility in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.