Organization
CLEAR SPACE MH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA V RODRIGUEZ LICSW (OWNER)
(401) 376-3093
Entity
Organization
Contact information
Practice address
212 CALLA ST, PROVIDENCE, RI 02905
(401) 376-3093
Mailing address
555 N MAIN ST # 1171, PROVIDENCE, RI 02904-5722
(401) 376-3093
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/12/2022
Last updated
12/18/2024
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