| NPI | 1124806674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE SHOPPELL Clinician 401-450-9231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2023-09-18 |