SRC PROVIDENCE, LLC
NPI 1447615034
Assisted Living Facility in Providence, RI

NPI Status: Active since December 23, 2015

Contact Information

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906
Phone: (401) 273-6565

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  • Organization
  • Assisted Living Facility

About SRC PROVIDENCE, LLC

This page provides the complete NPI Profile along with additional information for Src Providence, Llc, a provider established in Providence, Rhode Island operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1447615034 assigned on December 2015. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Tamilyn Levin (Chief Financial Officer)

NPI
1447615034
Provider Name
SRC PROVIDENCE, LLC
Entity Type
Organization
Location Address
353 BLACKSTONE BLVD PROVIDENCE, RI 02906
Location Phone
(401) 273-6565
Mailing Address
63 KENDRICK ST NEEDHAM, MA 02494
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-23-2015
Last Update Date
12-28-2015
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TAMILYN LEVIN

Authorized Official Title
CHIEF FINANCIAL OFFICER
Authorized Official Phone
(781) 707-9510

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1447615034
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
24871211006
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 8 + 7 + 1 + 2 + 1 + 1 + 0 + 0 + 6 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 44

The NPI number 1447615034 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 13 providers are registered at the same or nearby location.

EPOCH SL I INC

Skilled Nursing Facility

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 273-6565

MR. EDWARD RYAN HICKEY P.TX

Physical Therapist

(Geriatrics)

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 751-6900

EPOCH ON BLACKSTONE BOULEVARD, LLC

Skilled Nursing Facility

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 273-6565

SRC PROVIDENCE, LLC

Skilled Nursing Facility

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 273-6565

MRS. DANIELLE GISELE COUGHLIN MSPT

Physical Therapist

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 528-0319

STEFANIE LUFT MS, CCC-SLP

Speech-Language Pathologist

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 253-6565

DEANNA RECUPERO

Physical Therapist

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 235-0944

STEPHANIE CRABTREE

Occupational Therapist

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 273-6565

SHANA COLEMAN OTR/L

Occupational Therapist

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 273-6565

SRC BLACKSTONE OP, LLC

Assisted Living Facility

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 273-6565

MILESTONE REHAB, L.L.C.

Physical Therapist

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 751-6900

MS. DIANA NAVARRO OTR/L

Occupational Therapist

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 273-6565

JANELLE LINDSAY SCOTT OTR, MS

Occupational Therapist

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906

(401) 273-6565

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1447615034, enumerated as an "organization" on December 23, 2015.

The provider is located at 353 BLACKSTONE BLVD PROVIDENCE, RI 02906 and the phone number is (401) 273-6565.

Assisted Living Facility with taxonomy code 310400000X.