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Organization

BRATTLEBORO RETREAT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER BROUSSARD (BILLING SUPERVISOR)
(802) 258-4392
Entity
Organization

Contact information

Practice address
ANNA MARSH LANE, BRATTLEBORO, VT 05301
(802) 257-7785
(802) 258-3798
Mailing address
PO BOX 101, BRATTLEBORO, VT 05302-0101
(802) 257-7785
(802) 258-3798

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
649
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007212
VT
Enumeration date
06/20/2007
Last updated
08/22/2020
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