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General NPI Number Information
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NPI Number | 1164201562
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Entity Type | Organization
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Legal Business Name | OM FISHER HOME
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Dates
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Enumeration Date | 09/25/2023
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 171 WESTVIEW MEADOWS RD
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City | MONTPELIER
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State | VT
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Zip | 05602-3385
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Country | US
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Telephone | 802-223-1068
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Fax |
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Provider Business Mailing Address
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Address Line | 171 WESTVIEW MEADOWS RD
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City | MONTPELIER
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State | VT
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Zip | 05602-3385
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Country | US
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Telephone | 802-223-1068
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DAWN PALOWSKI
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Credential |
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Telephone | 802-223-1068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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