Healthcare Provider Details

I. General information

NPI: 1932108222
Provider Name (Legal Business Name): HELEN PORTER NURSING HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PORTER DR
MIDDLEBURY VT
05753-8422
US

IV. Provider business mailing address

30 PORTER DR
MIDDLEBURY VT
05753-8422
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-4001
  • Fax: 802-388-3474
Mailing address:
  • Phone: 802-388-4001
  • Fax: 802-388-3474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number270000163
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateVT

VIII. Authorized Official

Name: MS. JENNIFER BERTRAND
Title or Position: CFO
Credential:
Phone: 802-388-5607