NPI | 1316143142 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN BOLDUC Administrator 802-933-2511 |
Organization Subpart ? | No |
Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: VT 0144) |
Enumeration Date | 2007-06-27 |
Last Update Date | 2020-08-22 |