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KRE HUSKY PROVIDENCE LICENSEE LLC
NPI 1912567744
Assisted Living Facility in Providence, RI

Active since June 14, 2019CLIA 41D2203831 · Waiver
700 SMITH ST, PROVIDENCE, RI 02908(401) 648-0124 Get Directions Write a Review

NPPES record last updated: June 14, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kre Husky Providence Licensee Llc NPPES

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

KRE HUSKY PROVIDENCE LICENSEE LLC (NPI 1912567744) is a healthcare organization registered as an assisted living facility in Providence, Rhode Island and active in the NPI registry since June 2019. The organization holds a CLIA Waiver certificate valid through December 6, 2026 and lists Thomas H. Grape, President, as its authorized official.

NPPES Registry Identity

NPI1912567744
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameKRE HUSKY PROVIDENCE LICENSEE LLC
Location Address700 SMITH STProvidence, RI 02908-3500
Mailing Address201 Jones Rd Fl 3Waltham, MA 02451-1600
Phone(401) 648-0124
Organization SubpartNo
Authorized OfficialThomas H. GrapePresident · (781) 489-7100
Enumeration DateJune 14, 2019
✔ NPI 1912567744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
700 SMITH ST, Providence, RI 02908
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 41D2203831

Kre Husky Providence Licensee LLC · Providence, RI
Active · expires Dec 6, 2026
CLIA Number41D2203831
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 7, 2024
Certificate Expiration DateDecember 6, 2026
Laboratory DirectorPaige Menditto
Laboratory Phone(401) 521-0090
Laboratory LocationKre Husky Providence Licensee LLC700 Smith St, Providence, RI 02908
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

REBECCA MARY BROWN MD
Specialist
700 SMITH ST
PROVIDENCE, RI 02908
Providence County (401) 456-2000
B-X PROVIDENCE LLC
Assisted Living Facility
700 SMITH ST
PROVIDENCE, RI 02908
Providence County (401) 521-0090

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 Kre Husky Providence Licensee LLC's NPI number?

The NPI number for Kre Husky Providence Licensee LLC is 1912567744. It was assigned to this organization in the NPPES registry on June 14, 2019.

Where is Kre Husky Providence Licensee LLC located?

Kre Husky Providence Licensee LLC is located at 700 Smith St, Providence, RI 02908. The listed phone number is (401) 648-0124.

What is Kre Husky Providence Licensee LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Kre Husky Providence Licensee LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 41D2203831) is associated with this NPI, valid through December 6, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kre Husky Providence Licensee LLC was last updated on June 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.