NPI | 1134465784 |
---|---|
Doing Business As | FORTYSEVEN MAIN STREET, INC |
Entity Type | Organization |
Authorized Contact | WILLEM LEENMAN Director 802-468-5325 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Enumeration Date | 2012-12-28 |
Last Update Date | 2012-12-28 |