| NPI | 1639775893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN M FORTE Contract Liaison 401-846-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2023-03-14 |