| NPI | 1609646736 |
|---|---|
| Former Legal Business Name | TWICE FED WILDERNESS, LLC |
| Entity Type | Organization |
| Authorized Contact | MAXWELL ALEXANDER DUQUETTE Executive Director 802-585-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2024-01-30 |