NPI 1427422906

Src East Side, LLC

Organisation Assisted Living Facility Providence, RI

Practice location

Address: 1 Butler Ave, Providence, RI 02906-5119
Phone: (401) 275-0682
Mailing address: 63 Kendrick St, Needham, MA 02494-2708

Authorised official

Name: Tamilyn Levin
Title: Chief Financial Officer
Phone: (781) 707-9510

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

Other Assisted Living Facility providers in Rhode Island →

Registry record

NPI: 1427422906
Entity type: Organization
NPI issued: 20 Nov 2015
Record last updated: 20 Nov 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.