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1336513811
SRC PROVIDENCE, LLC
PROVIDENCE, RI
NPI
1336513811
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Entity Type
Organization
Authorized Contact
TAMILYN LEVIN
Chief Financial Officer
781-707-9510
Organization Subpart ?
No
Primary Taxonomy
314000000X Skilled Nursing Facility
Enumeration Date
2015-11-20
Last Update Date
2015-11-20
Business Address
SRC PROVIDENCE, LLC
353 BLACKSTONE BLVD
PROVIDENCE, RI 02906-4936
Phone number: 401-273-6565
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Mailing Address
SRC PROVIDENCE, LLC
63 KENDRICK ST
NEEDHAM, MA 02494-2708
Phone number:
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