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General NPI Number Information
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NPI Number | 1043038250
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Entity Type | Organization
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Legal Business Name | GREEN MOUNTAIN TOTAL CARE
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Dates
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Enumeration Date | 09/27/2024
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 1233 SHELBURNE RD STE 206
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-7733
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Country | US
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Telephone | 802-923-3434
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Fax |
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Provider Business Mailing Address
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Address Line | 1375 MAPLE TREE PL # 1067
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City | WILLISTON
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State | VT
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Zip | 05495-8210
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Country | US
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Telephone | 802-923-3434
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Fax |
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Authorized Official
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Title or Position | CO-OWNER, COO
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Name | KYLA RATHBONE
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Credential |
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Telephone | 802-923-3434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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