AVATAR RESIDENTIAL, INC. (NPI# 1225155336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225155336 |
| Entity Type | Organization |
| Organization Name | AVATAR RESIDENTIAL, INC. |
| Practice Address |
250 Garden Hills Dr Cranston RI 02920-3428 |
| Mailing Address |
33 College Hill Rd Building 33 Warwick RI 02886-2776 |
| Practice Telephone | 4014644064 |
| Mailing Telephone | 4018267500 |
| Mailing Fax Number | 4018267503 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KATHLEEN A. ELLIS (VICE PRESIDENT) |
| Authorized Official Telephone | 4018267500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 75 | RI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | PROVIDER NUMBER | AR01374 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093832339 | Avatar Residential, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 425 New River Rd, Manville, RI 02838-1805 | 2007-03-23 |
| 1053607754 | Avatar Residential, Inc. | Day Training, Developmentally Disabled Services | 33 College Hill Rd, Bldg.33, Warwick, RI 02886-2776 | 2011-06-22 |
| Street Address |
250 GARDEN HILLS DR |
| City | CRANSTON |
| State | RI |
| Zip Code | 02920-3428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184262198 | Beacon Dental Health Ri, PC | Clinic/Center | Beacon Dental Health Ri, P.C., 1090 New London Avenue, Cranston, RI 02920 | 2019-12-20 |
| 1821642240 | Jaime L Nixon | Dietitian, Registered | 444 Meshanticut Valley Parkway, Apt 37, Cranston, RI 02920 | 2019-07-25 |
| 1164923553 | Codac Inc | Peer Specialist | 3 Regan Ct, Cranston, RI 02920 | 2018-02-22 |
| 1144673096 | Joanne Le | Optometrist | 1400 Oaklawn Ave., Cranston, RI 02920 | 2016-07-15 |
| 1053790733 | Alanna Conley | Speech-Language Pathologist | 45 Sockanosset Cross Rd Ste 100, Cranston, RI 02920 | 2015-05-27 |
| 1114322740 | Nicole Enos | Physical Therapist | 51 Sockanosset Crossroad, Cranston, RI 02920 | 2014-10-24 |
| 1841622313 | Courtney Faiith Oliver | Occupational Therapy Assistant | 150 Midway Road, Suite 173, Cranston, RI 02920 | 2013-08-06 |
| 1386086403 | Sarah Gonzalez | Marriage & Family Therapist | 105 Sockanosset Cross Rd Ste 102, Cranston, RI 02920 | 2013-07-18 |
| 1902246788 | Amanda Lee Zarriello | Physical Medicine & Rehabilitation | 10 Worthington Rd, Cranston, RI 02920 | 2013-06-26 |
| 1962742528 | Yatyee Lee | Counselor | 141 Elmwood Avenue, Cranston, RI 02920 | 2013-02-19 |
| Find all providers in zip 02920 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790804334 | Re-focus Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 210 Olney Arnold Rd, Cranston, RI 02921-1502 | 2007-03-28 |
| 1376660043 | Avatar Residential Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15 Lillian Ln, Cranston, RI 02920-6200 | 2007-03-26 |
| 1356468011 | Avatar Residential Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9 Sherman Ave, Cranston, RI 02920-3813 | 2007-03-26 |
| 1871610980 | West Bay Residential Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 34 Thistle Dr, Cranston, RI 02920-3131 | 2007-03-23 |
| 1184740789 | West Bay Residential Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 155 Oakland Ave, Cranston, RI 02910-4525 | 2007-03-22 |
| 1164548798 | West Bay Residential Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 26 Knollwood Ave, Cranston, RI 02910-3115 | 2007-03-22 |
| 1861518847 | West Bay Residential Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 199 Glen Hills Dr, Cranston, RI 02920-3516 | 2007-03-22 |
| 1578689873 | West Bay Residential Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 150 Natick Ave, Cranston, RI 02921-1106 | 2007-03-21 |
| 1568588879 | West Bay Residential Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 183 Burdick Dr, Cranston, RI 02920-1519 | 2007-03-21 |
| 1740306042 | West Bay Residential Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 184 Whiting St, Cranston, RI 02920-4026 | 2007-03-21 |
| Find all providers in CRANSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.