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General NPI Number Information
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NPI Number | 1861265621
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Entity Type | Organization
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Legal Business Name | RUTLAND MENTAL HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 98 ALLEN ST
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City | RUTLAND
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State | VT
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Zip | 05701-4776
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Country | US
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Telephone | 802-775-2381
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Fax | 802-770-5438
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Provider Business Mailing Address
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Address Line | 78 S MAIN ST
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City | RUTLAND
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State | VT
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Zip | 05701-4591
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Country | US
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Telephone | 802-770-5417
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MICHAEL MORALES
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Credential |
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Telephone | 802-770-5417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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