| Name: | Avatar Residential, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 06 Sep 1991 (34 years ago) |
| Identification Number: | 000065577 |
| ZIP code: | 02886 |
| County: | Kent County |
| Principal Address: | 33 COLLEGE HILL ROAD BLDG 33, WARWICK, RI, 02886, USA |
| Purpose: | RESIDENTIAL SERVICES FOR ADULTS WITH PHYSICAL AND MENTAL DISABILITIES. |
NAICS
623210 Residential Intellectual and Developmental Disability FacilitiesThis industry comprises establishments (e.g., group homes, hospitals, intermediate care facilities) primarily engaged in providing residential care services for persons diagnosed with intellectual and developmental disabilities. These facilities may provide some health care, though the focus is room, board, protective supervision, and counseling. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053607754 | 2011-06-22 | 2011-06-22 | 33 COLLEGE HILL RD, BLDG.33, WARWICK, RI, 028862776, US | 33 COLLEGE HILL RD, BLDG.33, WARWICK, RI, 028862776, US | |||||||||||||||||||||||||
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| Phone | +1 401-826-7500 |
| Fax | 4018267503 |
Authorized person
| Name | KATHLEEN A ELLIS |
| Role | EXECUTIVE DIRECTOR |
| Phone | 4018267500 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| License Number | 136 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PROVIDER NUMBER |
| Number | AI54946 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| KATHLEEN ELLIS | Agent | 33 COLLEGE HILL ROAD BUILDING 33A, WARWICK, RI, 02886, USA |
| Name | Role | Address |
|---|---|---|
| KATHLEEN A. ELLIS | PRESIDENT | 243 SILVER LAKE AVE WAKEFIELD, RI 02879 USA |
| KATHLEEN A ELLIS | PRESIDENT | 33 COLLEGE HILL ROAD BLDG #33, BLDG 33 WARWICK, RI 02886 USA |
| Name | Role | Address |
|---|---|---|
| ALISSA FORLEO | VICE PRESIDENT | 40 STRATHMORE ROAD CRANSTON, RI 02905 USA |
| Number | Name | File Date |
|---|---|---|
| 202454852190 | Annual Report | 2024-05-24 |
| 202338676410 | Annual Report | 2023-06-26 |
| 202338011860 | Revocation Notice For Failure to File An Annual Report | 2023-06-19 |
| 202207908350 | Annual Report | 2022-01-12 |
| 202185946810 | Annual Report | 2021-01-12 |
| 202032095490 | Annual Report | 2020-01-13 |
| 201986944720 | Annual Report | 2019-02-19 |
| 201856186760 | Annual Report | 2018-01-16 |
| 201734135460 | Annual Report | 2017-02-15 |
| 201690976060 | Annual Report | 2016-01-20 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 343601266 | 0112300 | 2018-11-14 | 221 JILLSON AVENUE, WOONSOCKET, RI, 02895 | |||||||||||||
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| 343573192 | 0112300 | 2018-11-01 | 14 DEXTER ROCK ROAD, LINCOLN, RI, 02865 | |||||||||||||
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| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 9122707307 | 2020-05-01 | 0165 | PPP | 33 College Hill Rd Bldg 33, WARWICK, RI, 02886 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 08 Apr 2025
Sources: Rhode Island Department of State
