| NPI | 1881901825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK E LOGAN Medical Director 802-775-7798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2010-09-13 |