| NPI | 1467988683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA M BOURDEAU CFO 401-275-5038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: RI ACF01632) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 261QP2300X Clinic/Center, Primary Care (Licence: RI ACF01632) | |
| Enumeration Date | 2017-05-08 |
| Last Update Date | 2021-12-21 |