| NPI | 1295398345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGONEH BULLARD Owner 401-263-6467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2019-04-15 |