Organization
UNIQUE DIVERSITY INNOVATION LLC
Active
Organization
UNIQUE DIVERSITY INNOVATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANEE S VEGA LPIM (CEO)
(508) 345-4151
Entity
Organization
Contact information
Practice address
715 BRANCH AVE, PROVIDENCE, RI 02904-2248
(508) 345-4151
Mailing address
715 BRANCH AVE, PROVIDENCE, RI 02904-2248
(508) 345-4151
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SH23373
—
RI
Enumeration date
06/20/2025
Last updated
06/20/2025
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