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Organization
MISTY HEATHER MORN COMMUNITY CARE HOME
Active
Organization
MISTY HEATHER MORN COMMUNITY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FRANCETTA IRENE TICE R.N. (OWNER)
(802) 265-3300
Entity
Organization
Contact information
Practice address
174 BLISSVILLE RD, HYDEVILLE, VT 05750-0176
(802) 265-3300
(802) 265-3300
Mailing address
PO BOX 176, HYDEVILLE, VT 05750-0176
(802) 265-3300
(802) 265-3300
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
0174
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047W125
—
VT
05
—
047W187
—
VT
Enumeration date
05/17/2007
Last updated
08/22/2020
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