| NPI | 1790791069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL F SULLIVAN Social Worker |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: RI CSW 00303) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |