| NPI | 1821218587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIONEL H. FERNANDEZ Executive Director 401-785-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 251S00000X (Licence: RI 6131) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2023-07-14 |