| NPI | 1649994567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA SALOMAA Administrative Assistant 802-685-4458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |