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THE TAVARES PEDIATRIC CENTER INC

Intermediate Care Facility, Mentally Retarded

Providence, Rhode Island

Provider NPI: 1366442899

Organization Information:
Organization Name:  THE TAVARES PEDIATRIC CENTER INC


Practice Location:
101 PLAIN ST  PROVIDENCE, RI 02903 US
Tel: 401-272-7127  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
RIRI 642
X314000000XNursing & Custodial Care Facilities
Skilled Nursing Facility
RIRI 642

Other Provider Identifiers:

IssuerNumberStateType
41G085RI05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS RI - Page 1



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