| NPI | 1013734342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN REPSTAD Owner 802-782-2426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-09-26 |
| Last Update Date | 2024-09-26 |