| NPI | 1023298015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS BERGERON Administrator 802-626-3361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VT 0475044) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2025-08-26 |