| NPI | 1992053896 |
|---|---|
| Former Legal Business Name | PROVIDENCE CLUBHOUSE DEVELOPMENT GROUP |
| Entity Type | Organization |
| Authorized Contact | RALPH A. LORD Executive Director 401-273-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: RI 638.01) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2012-08-27 |