# COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** dba Mettowee Valley Family Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104870922
- **Authorized official:** MICHAEL L GARDNER (FINANCE DIRECTOR)
- **Authorized official phone:** (802) 855-2080

## Contact information

- **Practice address:** 278 VT ROUTE 149, WEST PAWLET, VT 05775-9798
- **Practice address phone:** (802) 645-0580
- **Practice address fax:** (802) 645-0587
- **Mailing address:** 71 ALLEN ST, SUITE 403, RUTLAND, VT 05701-4570
- **Mailing address phone:** (802) 772-4414
- **Mailing address fax:** (802) 772-7973

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 09/11/2018