SRC BLACKSTONE OP LLC NPI 1588200166

NPI Information

SRC BLACKSTONE OP, LLC is an assisted living facility in Providence, RI. The provider is 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. SRC BLACKSTONE OP, LLC NPI is 1588200166. The provider is registered as an organization entity type.

The provider's business location address is:

353 BLACKSTONE BLVD
PROVIDENCE, RI
ZIP 02906-936
Phone: (401) 273-6565
Fax: (401) 273-6568

The provider's authorized official is Jonathan Scharf .
The authorized official title is General Counsel and has the following contact phone number (781) 707-9030.

The enumeration date for this NPI number is 11/19/2019 and was last updated on 11/19/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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