Healthcare Provider Details

I. General information

NPI: 1144185703
Provider Name (Legal Business Name): WHITE RIVER VALLEY SUPERVISORY UNION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 WATERMAN RD
SOUTH ROYALTON VT
05068-5117
US

IV. Provider business mailing address

461 WATERMAN RD
SOUTH ROYALTON VT
05068-5117
US

V. Phone/Fax

Practice location:
  • Phone: 802-763-3811
  • Fax:
Mailing address:
  • Phone: 802-763-3811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TARA WEATHERELL
Title or Position: BUSINESS MANAGER
Credential:
Phone: 802-763-3811