The Tavares Pediatric Center INC
Intermediate Care Facility, Intellectual Disabilities in Providence, RI. Organization (NPI-2).
NPI number1366442899
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1366442899
- Entity type
- Organization (NPI-2)
- Legal business name
- The Tavares Pediatric Center INC
- Organization subpart
- No
- Enumeration date
- Jul 27, 2005
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 315P00000X | Intermediate Care Facility, Intellectual Disabilities | RI 642 | RI | Yes |
| 314000000X | Skilled Nursing Facility | RI 642 | RI |
Practice location
101 Plain StProvidence, RI 02903-4824
Phone 401-272-7127 · Fax 401-272-4752
Mailing address
101 Plain StProvidence, RI 02903-4824
Phone 401-272-7127 · Fax 401-272-4752
Authorized official
Eugene F Tavares
Administrator
4012727127
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Other Intellectual Disabilities Intermediate Care Facility providers in Providence, RI
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All 5 Intellectual Disabilities Intermediate Care Facility providers in Providence · All 11,044 providers in Providence
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