Provider Demographics
NPI:1619546124
Name:SABATERLAB FOUNDATION
Entity Type:Organization
Organization Name:SABATERLAB FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:IVELISSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SABATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-327-2442
Mailing Address - Street 1:PO BOX 41208
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02940-1208
Mailing Address - Country:US
Mailing Address - Phone:401-327-2442
Mailing Address - Fax:
Practice Address - Street 1:255 MAIN ST STE 206
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4026
Practice Address - Country:US
Practice Address - Phone:401-327-2442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SABATER LABORATORY FOR PSYCHOLOGICAL INNOVATIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-19
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty