| NPI | 1164627808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BROUSSARD Billing Supervisor 802-258-4392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital (Licence: VT 649) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2020-08-22 |