NPI | 1063574135 |
---|---|
Entity Type | Organization |
Authorized Contact | RAYMOND J LAVOIE Executive Director 401-312-9892 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: RI ACF01536) |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: RI ACF01536) |
Enumeration Date | 2006-12-15 |
Last Update Date | 2024-03-04 |