| NPI | 1598049454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELA DUPONT Program Manager 802-524-6534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VT 040.0080421) |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2011-10-10 |