| NPI | 1740460872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REYNARD BULLOCK Owner 401-932-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: RI mft00100) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2007-11-06 |