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General NPI Number Information
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NPI Number | 1316866569
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Entity Type | Organization
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Legal Business Name | PATHFINDER RECOVERY VT LLC
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 209 AUSTINE DR # 239
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City | BRATTLEBORO
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State | VT
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Zip | 05301-7223
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Country | US
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Telephone | 646-319-4150
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Fax | 203-210-8641
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Provider Business Mailing Address
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Address Line | 249 HARTLAND RD
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City | WEST GRANBY
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State | CT
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Zip | 06090-1012
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Country | US
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Telephone | 646-319-4150
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Fax | 203-210-8641
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL BRUNK
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Credential |
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Telephone | 646-319-4150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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