| NPI | 1598534828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAYWELL TEDOE Owner 401-419-2106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2023-12-28 |