| NPI | 1629285697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCETTA IRENE TICE Owner 802-265-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: VT 0174) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |