| NPI | 1588691620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CKARLA AGUDELO Credentialing Specialist 401-767-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: RI ACF01584) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 251B00000X Case Management | |
| 251S00000X (Licence: RI ACF01584) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-10-06 |