| NPI | 1871004754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PALO Owner 401-484-0407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2023-05-30 |