| NPI | 1992245849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CHRETIEN ERWIN Owner 802-873-3542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VT 089.0110618) |
| Enumeration Date | 2017-02-26 |
| Last Update Date | 2017-02-26 |