| NPI | 1285769174 |
|---|---|
| Former Legal Business Name | OURLADY OF PROVIDENCE |
| Entity Type | Organization |
| Authorized Contact | CARMEN PROULX Sister 802-655-2395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: VT 0198) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |