| NPI | 1174797161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE FORREST Medical Director 401-305-5230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: RI 1780698357) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |