Organization
THE TAVARES PEDIATRIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE F TAVARES LICENSED (ADMINISTRATOR)
(401) 272-7127
Entity
Organization
Contact information
Practice address
101 PLAIN ST, PROVIDENCE, RI 02903-4824
(401) 272-7127
(401) 272-4752
Mailing address
101 PLAIN ST, PROVIDENCE, RI 02903-4824
(401) 272-7127
(401) 272-4752
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
RI 642
RI
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
RI 642
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41G085
—
RI
Enumeration date
07/27/2005
Last updated
09/11/2025
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