| Centro De Innovacion Mujer Latina | |
|
640 Broad St Providence RI 02907-1463 | |
| (401) 390-6816 | |
| Not Available |
| Full Name | Centro De Innovacion Mujer Latina |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 640 Broad St, Providence, Rhode Island |
| Authorized Official Name and Position | Evylegna Marie Rodriguez (DIRECTORA EJECUTIVA) |
| Authorized Official Contact | 4013906816 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro De Innovacion Mujer Latina 2597 Hartford Ave Johnston RI 02919-1620 Ph: (401) 390-6816 | Centro De Innovacion Mujer Latina 640 Broad St Providence RI 02907-1463 Ph: (401) 390-6816 |
| NPI Number | 1992685358 |
|---|---|
| Provider Enumeration Date | 09/05/2025 |
| Last Update Date | 09/05/2025 |
| Certification Date | 09/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992685358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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