| NPI | 1093062903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CANCILLIERE Clinical Director 401-365-6855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: RI CSW01345) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2012-08-09 |