Organization
PROVIDENCE VA MEDICAL CENTER
Active
Other names
Southeastern Psychiatric Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLAN D. ERICKSON MD (CHIEF STAFF)
(401) 273-7100
Entity
Organization
Contact information
Practice address
830 CHALKSTONE AVENUE, PROVIDENCE, RI 02098-4799
(401) 273-7100
(401) 457-3354
Mailing address
830 CHALKSTONE AVENUE, PROVIDENCE, RI 02098-4799
(401) 273-7100
(401) 457-3354
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
18598
RI
Other
Enumeration date
07/25/2006
Last updated
08/22/2020
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