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General NPI Number Information
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NPI Number | 1750295879
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Entity Type | Organization
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Legal Business Name | GREEN MOUNTAIN RECOVERY LLC
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 128 LAKESIDE AVE STE 225
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City | BURLINGTON
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State | VT
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Zip | 05401-5098
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Country | US
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Telephone | 802-272-4982
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Fax |
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Provider Business Mailing Address
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Address Line | 128 LAKESIDE AVE STE 225
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City | BURLINGTON
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State | VT
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Zip | 05401-5098
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DANIEL CUTLER
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Credential |
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Telephone | 802-272-4982
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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 | NULL
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