| NPI | 1083473425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROOSEVELT DALE President 401-516-8958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-03-18 |