| |
85 A Chad Brown Street Providence RI 02908 | |
(401) 274-6339 | |
(401) 831-5953 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 85 A Chad Brown Street, Providence, Rhode Island |
Authorized Official Name and Position | Kevin Cabral (CFO) |
Authorized Official Contact | 4014440400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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375 Allens Ave Providence RI 02905-5010 Ph: (401) 444-0400 | 85 A Chad Brown Street Providence RI 02908 Ph: (401) 274-6339 |
NPI Number | 1669596367 |
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Provider Enumeration Date | 03/19/2007 |
Last Update Date | 12/05/2024 |
Identifier | Type | State | Issuer |
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1669596367 | NPI | - | NPPES |
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