| NPI | 1932326386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMUND H MOORE CFO 802-463-3294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |