Provider Demographics
NPI:1922982602
Name:BRAVE ROOTS TURTLE POND
Entity type:Organization
Organization Name:BRAVE ROOTS TURTLE POND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:516-384-0547
Mailing Address - Street 1:48 SAINT GEORGE CT
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-5425
Mailing Address - Country:US
Mailing Address - Phone:516-384-0547
Mailing Address - Fax:
Practice Address - Street 1:48 SAINT GEORGE CT
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-5425
Practice Address - Country:US
Practice Address - Phone:516-384-0547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric