# OUR LADY OF PROVIDENCE VT. INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OurLady of Providence
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285769174
- **Authorized official:** CARMEN PROULX (SISTER)
- **Authorized official phone:** (802) 655-2395

## Contact information

- **Practice address:** 47 W SPRING ST, WINOOSKI, VT 05404-1319
- **Practice address phone:** (802) 655-2395
- **Mailing address:** 47 W SPRING ST, WINOOSKI, VT 05404-1319
- **Mailing address phone:** (802) 655-2395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 0198 | VT | Yes |

## Other

- **Enumeration date:** 02/22/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 047W152 | — | VT |
| 05 | — | 047W267 | — | VT |