| NPI | 1114212271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA DEGENNARO Clinical Director 802-295-5078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VT 068-0000181) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |