Organization · Type 2 NPI

SRC Blackstone Op, LLC

Assisted Living Facility · Providence, RI

NPI number 1588200166 Active

Practice location

353 Blackstone Blvd
Providence, RI 02906-4936

Call (401) 273-6565 Map

Fax (401) 273-6568

Mailing address

C/o Wingate Healthcare, Inc., 63 Kendrick Street
Needham, MA 02494

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000XNone listed

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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About NPI 1588200166

SRC Blackstone Op, LLC's National Provider Identifier is 1588200166, issued on Nov 19, 2019. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Providence, RI. The record was last updated on Nov 19, 2019.