| NPI | 1245127620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY LUTHER Access Manager Credentialing 802-775-2381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-06-19 |
| Last Update Date | 2025-06-23 |