Healthcare Provider Details

I. General information

NPI: 1326449497
Provider Name (Legal Business Name): PATHWAYS TO HOUSING VT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 NORTH ST
BURLINGTON VT
05401-4247
US

IV. Provider business mailing address

1233 SHELBURNE RD SUITE E6
SOUTH BURLINGTON VT
05403-7700
US

V. Phone/Fax

Practice location:
  • Phone: 888-492-8218
  • Fax: 855-362-2766
Mailing address:
  • Phone: 888-492-8218
  • Fax: 855-362-2766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HILARY MELTON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 888-492-8218