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General NPI Number Information
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NPI Number | 1871634352
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Entity Type | Organization
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Legal Business Name | FOUR C'S INC.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 642 SHELDON RD
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City | SAINT ALBANS
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State | VT
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Zip | 05478-8014
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Country | US
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Telephone | 802-524-2996
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Fax | 802-524-7634
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Provider Business Mailing Address
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Address Line | 642 SHELDON RD
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City | SAINT ALBANS
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State | VT
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Zip | 05478-8014
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Country | US
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Telephone | 802-524-2996
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Fax | 802-524-7634
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. COLEEN KARA CONDON
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Credential | NHA
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Telephone | 802-524-2996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | 0541
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License Number State | VT
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