| NPI | 1821722125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYLAN PUSHEE Owner/Single Member 802-333-4829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-15 |