| NPI | 1972662104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON CONTRERAS Controller 401-276-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2009-04-30 |