Organization
TAVARES PEDIATRIC CENTER
Active
Other names
Tavares Pediatric Center
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN M TAVARES (FIN ADM)
(401) 272-7127
Entity
Organization
Contact information
Practice address
101 PLAIN ST, PROVIDENCE, RI 02903-4828
(401) 272-7127
(401) 272-4752
Mailing address
101 PLAIN ST, PROVIDENCE, RI 02903-4828
(401) 272-7127
(401) 272-4752
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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