| NPI | 1376708560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CKARLA AGUDELO Director Of Credentialing 401-767-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: RI ACF01610) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: RI ACF01610) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2025-04-04 |