# STATE STREET ENTERPRISE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Davis Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922130236
- **Authorized official:** MS. CARRIE J PATCH (MANAGER)
- **Authorized official phone:** (802) 674-5300

## Contact information

- **Practice address:** 45 STATE ST, WINDSOR, VT 05089-1213
- **Practice address phone:** (802) 674-5300
- **Practice address fax:** (802) 674-5388
- **Mailing address:** 45 STATE ST, WINDSOR, VT 05089-1213
- **Mailing address phone:** (802) 674-5300
- **Mailing address fax:** (802) 674-5388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 0021 | VT | Yes |

## Other

- **Enumeration date:** 03/12/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 047W175 | — | VT |
| 05 | — | 047W179 | — | VT |