Organization
AVATAR RESIDENTIAL, INC.
Active
Organization
AVATAR RESIDENTIAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN A. ELLIS (VICE PRESIDENT)
(401) 826-7500
Entity
Organization
Contact information
Practice address
250 GARDEN HILLS DR, CRANSTON, RI 02920-3428
(401) 464-4064
Mailing address
33 COLLEGE HILL RD, BUILDING 33, WARWICK, RI 02886-2776
(401) 826-7500
(401) 826-7503
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
75
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AR01374
PROVIDER NUMBER
RI
Enumeration date
03/23/2007
Last updated
08/22/2020
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