| NPI | 1407911431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY M JOHNSON Owner Manager 802-767-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: VT 0170) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |