Healthcare Provider Details

I. General information

NPI: 1134527559
Provider Name (Legal Business Name): ORLEANS SW SUPERVISORY UNION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2014
Last Update Date: 12/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 DANIELS RD
HARDWICK VT
05843
US

IV. Provider business mailing address

320 SCHOOL HILL DRIVE
WOLCOTT VT
05680
US

V. Phone/Fax

Practice location:
  • Phone: 802-472-3210
  • Fax: 802-472-6295
Mailing address:
  • Phone: 802-472-6551
  • Fax: 802-472-6295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateVT

VIII. Authorized Official

Name: MS. JOANNE LEBLANC
Title or Position: SUPERINTENDENT
Credential: MED.
Phone: 802-888-8465