AVATAR RESIDENTIAL INC. (NPI# 1518084508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518084508 |
| Entity Type | Organization |
| Organization Name | AVATAR RESIDENTIAL INC. |
| Practice Address |
102 Deerfield Dr West Warwick RI 02893-3240 |
| Mailing Address |
33 College Hill Rd Building 33 Warwick RI 02886-2776 |
| Practice Telephone | 4018211541 |
| Mailing Telephone | 4018267500 |
| Mailing Fax Number | 4018267503 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KATHLEEN A. ELLIS (VICE PRESIDENT) |
| Authorized Official Telephone | 4018267500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 324 | RI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | PROVIDER NUMBER | AD37249 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376660043 | Avatar Residential Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15 Lillian Ln, Cranston, RI 02920-6200 | 2007-03-26 |
| 1356468011 | Avatar Residential Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9 Sherman Ave, Cranston, RI 02920-3813 | 2007-03-26 |
| 1457478125 | Avatar Residential Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 221 Jillson Ave, Woonsocket, RI 02895-5934 | 2007-03-26 |
| 1982721056 | Avatar Residential Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Bertenshaw Rd, Woonsocket, RI 02895-6005 | 2007-03-23 |
| 1649397795 | Avatar Residential Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Dexter Rock Rd, Lincoln, RI 02865-1420 | 2007-03-23 |
| 1528185600 | Avatar Residential Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 294 Buttonwoods Ave, Warwick, RI 02886-7545 | 2007-03-23 |
| 1366569030 | Avatar Residential Inc. | Community/Behavioral Health | 33 College Hill Rd, Building 33, Warwick, RI 02886-2776 | 2007-03-26 |
| Street Address |
102 DEERFIELD DR |
| City | WEST WARWICK |
| State | RI |
| Zip Code | 02893-3240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528596012 | Nicholas James Ferro | Social Worker | 125 Providence St Unit N403, West Warwick, RI 02893 | 2017-05-26 |
| 1255636486 | Kathleen Ann Glancy | Registered Nurse | 4 Silverwood Lane, West Warwick, RI 02893 | 2011-01-19 |
| 1659549764 | Kerri Lynn Kyriakakis | Counselor | 1 James P. Murphy Highway, West Warwick, RI 02893 | 2008-02-12 |
| 1962685263 | Granite Harbor Business Development LLC | Point of Service | 1 James P. Murphy Industrial Highway, West Warwick, RI 02893 | 2007-12-10 |
| 1497811707 | Luann M Kelly | Registered Nurse | 37 Washington Street, West Warwick, RI 02893 | 2006-12-29 |
| 1679638530 | Vantage Point | Exclusive Provider Organization | 1 James P Murphy Highway, Suite 103, West Warwick, RI 02893 | 2006-12-22 |
| 1528123478 | Kathleenn Ann Carty | Counselor | 1james P. Murphy Highway, Suite 103, West Warwick, RI 02893 | 2006-12-22 |
| 1972672699 | Lee S Lovitz | Podiatrist | 1193 Tiogue Avenue, Coventry, RI 02893 | 2006-11-07 |
| 1003901497 | Mary Rose | Nurse Practitioner | 186 Providence Street, West Warwick, RI 02893 | 2006-10-03 |
| 1477659795 | Sandra Ann Wheller | Registered Nurse | Kent Center Mtt 2, West Warwick, RI 02893 | 2006-09-15 |
| Find all providers in zip 02893 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295851590 | West Bay Residential Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35 Lancelotta St, West Warwick, RI 02893-1716 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639307176 | Perspectives Corporation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 53 Dockray Street, Wakefield, RI 02879 | 2009-06-23 |
| 1740302082 | Spurwinkri-brook Drive | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10 Brook Dr, Hope Valley, RI 02832-2504 | 2007-04-06 |
| 1275655425 | Spurwink Ri - Crompton Road | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 106 Crompton Rd, East Greenwich, RI 02818-1202 | 2007-04-06 |
| 1699897942 | Spurwink Ri-south County Trail | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2944 S County Trl, East Greenwich, RI 02818-1429 | 2007-04-06 |
| 1700908969 | Spurwink Ri - Peaked Rock Road | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 33 Peaked Rock Rd, Wakefield, RI 02879-2380 | 2007-04-06 |
| 1235251489 | Spurwink Ri - Seven Mile Road | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 569 Seven Mile Rd, Hope, RI 02831-1850 | 2007-04-06 |
| 1467574624 | Spurwink Ri - Plainfield Pike | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1150 Plainfield Pike, Cpu Summit General Store, RI 02827-1904 | 2007-04-06 |
| 1881713733 | Re-focus Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 18 11th St, Providence, RI 02906-2910 | 2007-03-29 |
| 1982723987 | Re-focus Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Cooke Dr, North Scituate, RI 02857-1609 | 2007-03-29 |
| 1154440188 | Re-focus Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 179 Bourne St, North Providence, RI 02904-3707 | 2007-03-29 |
| Find all providers with the same taxonomy | ||||
| City | WEST WARWICK |
| Zip Code | 02893 |
Please comment or provide details below to improve the information on AVATAR RESIDENTIAL INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.