HOLTON HOME, INC.
Custodial Care Facility
Brattleboro, Vermont
Provider NPI: 1457497372
Organization Information:Organization Name: HOLTON HOME, INC.
Practice Location:
158 WESTERN AVE BRATTLEBORO, VT 05301 US
Tel: 802-254-4155 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
158 WESTERN AVE BRATTLEBORO, VT 05301 US
Tel: 802-254-4155 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311Z00000X | Nursing & Custodial Care Facilities Custodial Care Facility | VT | 48 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
047W123 | VT | 05 | |
047R020 | VT | 05 | |
047W043 | VT | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin