| NPI | 1225791080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ROCHE Owner 401-450-9625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2021-10-19 |