| NPI | 1902046675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH J PROVENZA Executive Director 802-442-5491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2009-02-20 |