# KINGDOM KARE REHABILITATION CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maple Lane Nursing Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518156603
- **Authorized official:** MR. TRAVIS BERGERON NHA (ADMINISTRATOR)
- **Authorized official phone:** (802) 754-8575

## Contact information

- **Practice address:** 60 MAPLE LN, BARTON, VT 05822-9494
- **Practice address phone:** (802) 754-8575
- **Mailing address:** 60 MAPLE LN, BARTON, VT 05822-9494
- **Mailing address phone:** (802) 754-8575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 0475044 | VT | Yes |

## Other

- **Enumeration date:** 10/15/2007
- **Last updated:** 08/27/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1568434629 | — | VT |