Healthcare Provider Details
I. General information
NPI: 1952412017
Provider Name (Legal Business Name): VERMONT CATHOLIC CHARITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2006
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
243 NORTH PROSPECT STREET
BURLINGTON VT
05401-1609
US
IV. Provider business mailing address
55 JOY DRIVE
SOUTH BURLINGTON VT
05403-0000
US
V. Phone/Fax
- Phone: 802-864-0263
- Fax: 802-864-5640
- Phone: 802-658-6111
- Fax: 802-860-0451
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | 0155 |
| License Number State | VT |
VIII. Authorized Official
Name: MRS.
DENISE
M
PAYEA
Title or Position: BUSINESS MANAGER
Credential:
Phone: 802-658-6111