Organization
OCEAN STATE BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DORVAL LICSW (PROVIDER)
(401) 626-0169
Entity
Organization
Contact information
Practice address
1524 ATWOOD AVE STE 244, JOHNSTON, RI 02919-3228
(401) 626-0169
Mailing address
1524 ATWOOD AVE STE 244, JOHNSTON, RI 02919-3228
(401) 626-0169
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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