| NPI | 1598898520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAES R. GANNAWAY Division Director 401-781-3669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: RI 45665) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |