| NPI | 1932232527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MORALES Billing Manager 802-770-5417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2023-09-07 |