| NPI | 1053177725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA CHELEVALLAH Owner 401-829-2654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-02-21 |
| Last Update Date | 2024-02-21 |