| Name: | Tavares Pediatric Center |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 03 Jan 2020 (5 years ago) |
| Identification Number: | 001703149 |
| ZIP code: | 02903 |
| County: | Providence County |
| Principal Address: | 101 PLAIN STREET, PROVIDENCE, RI, 02903, USA |
| Purpose: | TO OPERATE A NURSING FACILITY SERVING CHILDREN AND YOUNG ADULTS WITH SEVERE MEDICAL AND/OR DEVELOPMENTAL DISABILITIES |
| Historical names: |
TPC, Inc. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598368235 | 2020-11-17 | 2020-11-17 | 101 PLAIN ST, PROVIDENCE, RI, 029034828, US | 101 PLAIN ST, PROVIDENCE, RI, 029034828, US | |||||||||||||||
|
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| Phone | +1 401-272-7127 |
| Fax | 4012724752 |
Authorized person
| Name | VIVIAN M TAVARES |
| Role | FIN ADM |
| Phone | 4012727127 |
Taxonomy
| Taxonomy Code | 315P00000X - Intellectual Disabilities Intermediate Care Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MICHAEL G. TAUBER, ESQ. | Agent | 301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA |
| Name | Role | Address |
|---|---|---|
| VIVIAN M. TAVARES | PRESIDENT | 101 PLAIN STREET PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| JAMES NADEAU | DIRECTOR | 101 PLAIN STREET PROVIDENCE, RI 02908 USA |
| VIVIAN M. TAVARES | DIRECTOR | 101 PLAIN STREET PROVIDENCE, RI 02903-4829 USA |
| RICHARD GRECO, M.D. | DIRECTOR | 262 WILSON AVENUE RUMFORD, RI 02916 USA |
| MARION EDWARD, R.N. | DIRECTOR | 565 HARTFORD PIKE NORTH SCITUATE, RI 02857 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2020-11-05 | TPC, Inc. | Tavares Pediatric Center |
| Number | Name | File Date |
|---|---|---|
| 202447528860 | Annual Report | 2024-02-29 |
| 202333513710 | Annual Report - Amended | 2023-04-21 |
| 202330912930 | Annual Report | 2023-03-15 |
| 202215171780 | Annual Report | 2022-04-19 |
| 202100489640 | Statement of Change of Registered/Resident Agent | 2021-08-30 |
| 202196352130 | Annual Report | 2021-05-10 |
| 202072034280 | Articles of Amendment | 2020-11-05 |
| 202031024040 | Articles of Incorporation | 2020-01-03 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
