| NPI | 1093713174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN MARIE FORTE Contract Liaison And Credentialing 401-848-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: RI 626) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2024-04-25 |