| Undividual Inc | |
|
144 Waterman St Ste 1 Providence RI 02906-2126 | |
| (401) 578-8775 | |
| (401) 533-9532 |
| Full Name | Undividual Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 144 Waterman St Ste 1, Providence, Rhode Island |
| Authorized Official Name and Position | Maureeen Ann Walsh (PRESIDENT) |
| Authorized Official Contact | 4015788775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Undividual Inc 1 Richmond Sq Suite 103k Providence RI 02906-5139 Ph: (401) 274-8472 | Undividual Inc 144 Waterman St Ste 1 Providence RI 02906-2126 Ph: (401) 578-8775 |
| NPI Number | 1235307398 |
|---|---|
| Provider Enumeration Date | 02/12/2008 |
| Last Update Date | 02/11/2022 |
| Certification Date | 02/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235307398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 00116 (Rhode Island) | Primary |
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