Healthcare Provider Details

I. General information

NPI: 1538293451
Provider Name (Legal Business Name): RUTLAND COMMUNITY PROGRAMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 COURT ST
RUTLAND VT
05701-4032
US

IV. Provider business mailing address

78 S MAIN ST
RUTLAND VT
05701-4530
US

V. Phone/Fax

Practice location:
  • Phone: 802-747-3587
  • Fax: 802-747-7689
Mailing address:
  • Phone: 802-775-2381
  • Fax: 802-747-7699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS J POUR
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 802-775-4340