Healthcare Provider Details

I. General information

NPI: 1518078666
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

47 HERRICK ROAD
DERBY LINE VT
05830-8759
US

IV. Provider business mailing address

55 JOY DRIVE
SOUTH BURLINGTON VT
05403-0000
US

V. Phone/Fax

Practice location:
  • Phone: 802-873-3152
  • Fax: 802-864-7297
Mailing address:
  • Phone: 802-658-6111
  • Fax: 802-860-0451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number0143
License Number StateVT

VIII. Authorized Official

Name: MRS. DENISE M PAYEA
Title or Position: BUSINESS MANAGER
Credential:
Phone: 802-658-6111