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Organization
NORTH COUNTRY HEALTH SERVICES INC
Active
Organization
NORTH COUNTRY HEALTH SERVICES INC
Active
Other names
Derby Green
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA ANN BOHLMAN RN BSN CCM (ADMINISTRATOR)
(802) 766-2126
Entity
Organization
Contact information
Practice address
2853 US ROUTE 5, DERBY, VT 05829-9629
(802) 766-2201
(802) 766-2031
Mailing address
PO BOX 24, 2853 US RTE 5, DERBY, VT 05829-0024
(802) 766-2201
(802) 766-2031
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
47E054
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
475048
—
VT
Enumeration date
09/06/2005
Last updated
08/22/2020
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