| NPI | 1730173741 |
|---|---|
| Doing Business As | DERBY GREEN |
| Entity Type | Organization |
| Authorized Contact | LISA ANN BOHLMAN Administrator 802-766-2126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VT 47E054) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2020-08-22 |