| NPI | 1508936733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY F BUSKEY Administrator 802-877-3562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: VT 0311) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |