| NPI | 1013572940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNIE C HARDY Chief Executive Officer 802-250-1282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QC1500X Clinic/Center, Community Health | |
| 174200000X | |
| 177F00000X Lodging | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2019-05-06 |