| NPI | 1598914103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLIS VALE BURKHART Owner 401-246-0214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: RI MHC00226) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-18 |