| NPI | 1215394333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY ANN VANDEWEERT Billing Manager 802-388-6751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VT 089.0069978) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2024-01-11 |