Provider First Line Business Practice Location Address:
134 THURBERS AVE.
Provider Second Line Business Practice Location Address:
C/O FAMILY SERVICE OF RHODE ISLAND
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-331-1350
Provider Business Practice Location Address Fax Number:
401-277-3366
Provider Enumeration Date:
09/28/2006