| NPI | 1720650823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER CAMARA Finance 401-585-7534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2021-07-16 |