| Unique Diversity Innovation Llc | |
|
715 Branch Ave Providence RI 02904-2248 | |
| (508) 345-4151 | |
| Not Available |
| Full Name | Unique Diversity Innovation Llc |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 715 Branch Ave, Providence, Rhode Island |
| Authorized Official Name and Position | Shanee S Vega (CEO) |
| Authorized Official Contact | 5083454151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Unique Diversity Innovation Llc 715 Branch Ave Providence RI 02904-2248 Ph: (508) 345-4151 | Unique Diversity Innovation Llc 715 Branch Ave Providence RI 02904-2248 Ph: (508) 345-4151 |
| NPI Number | 1376430470 |
|---|---|
| Provider Enumeration Date | 06/20/2025 |
| Last Update Date | 06/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376430470 | NPI | - | NPPES |
| SH23373 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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