| NPI | 1609653765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMON OLUGBENGA ADEYEMI Administrator 401-282-0856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251E00000X Home Health |
| 251X00000X Supports Brokerage | |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2023-09-12 |