Healthcare Provider Details

I. General information

NPI: 1649481672
Provider Name (Legal Business Name): SCENIC VIEW COMMUNITY CARE HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

979 VT ROUTE 100
WESTFIELD VT
05874-9797
US

IV. Provider business mailing address

PO BOX 154
WESTFIELD VT
05874-0154
US

V. Phone/Fax

Practice location:
  • Phone: 802-744-6554
  • Fax:
Mailing address:
  • Phone: 802-744-6554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number0151
License Number StateVT

VIII. Authorized Official

Name: LYNE B LIMOGES
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 802-744-6554