| NPI | 1124292529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BRUNELL Billing Manager 802-488-6924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251S00000X | |
| 261Q00000X Clinic/Center | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2021-05-07 |