| NPI | 1639638331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN ELAINE SERRA Executive Director 401-789-9390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251B00000X Case Management |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2022-08-22 |