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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