| NPI | 1225505415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE MOORE Manager 401-441-2501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2019-01-17 |