| NPI | 1669840617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD W ELLISON Owner/Clinician 401-447-5952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: RI ISW02033) |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |