NPIMap

Organization Active NPI

Avatar Residential Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Woonsocket, RI
National Provider Identifier
1982721056
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
219 Issued in RI
Legal business name
AVATAR RESIDENTIAL INC.
Practice address
111 Bertenshaw Rd
Woonsocket, RI 02895-6005
Phone
(401) 766-8257
NPI assigned
Mar 23, 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 219 RI Primary

Addresses

Primary practice location

111 Bertenshaw Rd
Woonsocket, RI 02895-6005

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
AR01378OtherRIPROVIDER 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.

Locations

111 Bertenshaw Rd
Woonsocket, RI 02895
Phone (401) 766-8257

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982721056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 COLLEGE HILL RD",
            "address_2": "BIULDING 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": "111 BERTENSHAW RD",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956005",
            "telephone_number": "401-766-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVATAR RESIDENTIAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "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": "219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "AR01378",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, 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.