| NPI | 1720114168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES M. VAN DA GRIFF Director 802-457-1310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: VT 0135) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |