| NPI | 1104847946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA SOSA Payer Credentialing Specialist 401-921-7374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| 163W00000X Registered Nurse | |
| 175T00000X Peer Specialist | |
| 207SG0205X Medical Genetics Ph.D. Medical Genetics | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health (Licence: RI 631) | |
| 261QH0100X Clinic/Center Health Service | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-05-10 |