| NPI | 1326866872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE TOWNSEND Clinical Adminstrator 802-448-9909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 251J00000X Nursing Care |
| 251S00000X Community/Behavioral Health | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-10-02 |
| Last Update Date | 2024-10-02 |