| NPI | 1790227932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA PERRY Director Of Clinical Services 401-353-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: RI PT01788) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-11-04 |