Organization
WINTERGREEN RESIDENTIAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JENSEN (OWNER/MEMBER)
(802) 465-4101
Entity
Organization
Contact information
Practice address
3 UNION ST, BRANDON, VT 05733-1127
(802) 465-4101
Mailing address
PO BOX 206, BRANDON, VT 05733-0206
(802) 465-4101
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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