| NPI | 1811591597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ROBERT Accounting Clerk 401-490-7610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2024-03-06 |