| NPI | 1225801731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN MARIE FORTE Contract Liaison And Credentialing 401-848-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-12-27 |