| NPI | 1790862829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JOHANNS ERICKSON Presisdent 802-644-8708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: VT 0214) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |