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General NPI Number Information
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NPI Number | 1366522005
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Entity Type | Organization
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Legal Business Name | THE MANOR INC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 06/21/2011
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Provider Practice Location Address
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Address Line | 577 WASHINGTON HIGHWAY
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City | MORRISVILLE
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State | VT
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Zip | 05661
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Country | US
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Telephone | 802-888-8700
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Fax | 802-888-8782
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Provider Business Mailing Address
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Address Line | 577 WASHINGTON HIGHWAY
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City | MORRISVILLE
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State | VT
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Zip | 05661
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Country | US
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Telephone | 802-888-8700
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Fax | 802-888-8782
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LYNNETTE A SMITH
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Credential |
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Telephone | 802-888-8752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 0378
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 0270000273
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License Number State | VT
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