SRC PROVIDENCE, LLC
NPI 1336513811
Skilled Nursing Facility in Providence, RI

Active since November 20, 2015
353 BLACKSTONE BLVD, PROVIDENCE, RI 02906(401) 273-6565 Get Directions Write a Review

NPPES record last updated: November 20, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Src Providence, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SRC PROVIDENCE, LLC (NPI 1336513811) is a healthcare organization registered as a skilled nursing facility in Providence, Rhode Island and active in the NPI registry since November 2015. The organization lists Tamilyn Levin, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1336513811
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameSRC PROVIDENCE, LLC
Location Address353 BLACKSTONE BLVDProvidence, RI 02906-4936
Mailing Address63 Kendrick StNeedham, MA 02494-2708
Organization SubpartNo
Authorized OfficialTamilyn LevinChief Financial Officer · (781) 707-9510
Enumeration DateNovember 20, 2015
NPI 1336513811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

353 BLACKSTONE BLVD, Providence, RI 02906

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
353 BLACKSTONE BLVD
PROVIDENCE, RI 02906
Physical Therapist (Geriatrics)
353 BLACKSTONE BLVD
PROVIDENCE, RI 02906
Skilled Nursing Facility
353 BLACKSTONE BLVD
PROVIDENCE, RI 02906
Assisted Living Facility
353 BLACKSTONE BLVD
PROVIDENCE, RI 02906
Physical Therapist
353 BLACKSTONE BLVD
PROVIDENCE, RI 02906
Speech-Language Pathologist
353 BLACKSTONE BLVD
PROVIDENCE, RI 02906
Physical Therapist
353 BLACKSTONE BLVD
PROVIDENCE, RI 02906
Occupational Therapist
353 BLACKSTONE BLVD
PROVIDENCE, RI 02906

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Src Providence, LLC's NPI number?

The NPI number for Src Providence, LLC is 1336513811. It was assigned to this organization in the NPPES registry on November 20, 2015.

Where is Src Providence, LLC located?

Src Providence, LLC is located at 353 Blackstone Blvd, Providence, RI 02906. The listed phone number is (401) 273-6565.

What is Src Providence, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Src Providence, LLC was last updated on November 20, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.