| NPI | 1922051242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE M FITZSIMMONS Business Manager 802-446-2640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2015-11-23 |