Graduated: 2020
NPI: 1861090508
Practice Locations (2)
PROSPECT CHARTERCARE SJHSRI LLC
200 HIGH SERVICE AVE, FATIMA HOSPITAL PSYCHIATRIC/SOCIAL SERVICES
N PROVIDENCE, RI 029045113
4014563496
PROSPECT CHARTERCARE RWMC, LLC
825 CHALKSTONE AVE
PROVIDENCE, RI 029084728
4014562000
Source: CMS National Downloadable File, September 2026.