| NPI | 1366056830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CKARLA AGUDELO Credentialing Assistant 401-767-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |