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50 Health Ln Warwick RI 02886-2711 | |
| (401) 738-4229 | |
| (401) 738-8634 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 50 Health Ln, Warwick, Rhode Island |
| Authorized Official Name and Position | Daniel Kubas Meyer (PRESIDENT/CEO) |
| Authorized Official Contact | 4016910000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
50 Health Ln Warwick RI 02886-2711 Ph: (401) 738-4229 | 50 Health Ln Warwick RI 02886-2711 Ph: (401) 738-4229 |
| NPI Number | 1902355399 |
|---|---|
| Provider Enumeration Date | 09/26/2016 |
| Last Update Date | 01/19/2023 |
| Certification Date | 01/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902355399 | NPI | - | NPPES |
| 9001843 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 630 (Rhode Island) | Primary |
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