| NPI | 1386762698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA B MATHER Director 401-789-2244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: RI 46926) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |