| NPI | 1790262541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH E BOSTON Manager 802-681-8548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2025-02-17 |