Organization
47 MAIN STREET CORPORATION
Active
Organization
47 MAIN STREET CORPORATION
Active
Other names
Fortyseven Main Street, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
WILLEM LEENMAN MHSA (DIRECTOR)
(802) 468-5325
Entity
Organization
Contact information
Practice address
706 MAIN STREET, CASTLETON, VT 05735-0038
(800) 287-5325
(802) 468-5152
Mailing address
PO BOX 38, 706 MAIN STREET, CASTLETON, VT 05735-0038
(800) 287-5325
(802) 468-5152
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/28/2012
Last updated
12/28/2012
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