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General NPI Number Information
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NPI Number | 1790100246
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Entity Type | Organization
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Legal Business Name | RUTLAND HEALTH AND REHAB CENTER
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 02/20/2014
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Provider Practice Location Address
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Address Line | 46 NICHOLS ST
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City | RUTLAND
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State | VT
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Zip | 05701-3275
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Country | US
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Telephone | 802-775-2941
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Fax |
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Provider Business Mailing Address
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Address Line | 45 MCADAM RD
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City | WESTMORELAND
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State | NH
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Zip | 03467-4306
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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 | REHAB DIRECTOR
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Name | MRS. DAWN BAZAN
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Credential |
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Telephone | 802-775-2941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 073.0000200
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License Number State | VT
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