| NPI | 1376672402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JIMERSON Medical Director 802-388-6751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2011-10-18 |