| NPI | 1720763659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA PAULINE GUYETTE Agent 802-598-7969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2023-06-19 |