Organization
DYNAMIC ENGAGEMENT INSTITUTE, L3C
Active
Other names
Sapphire Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE AARON FOUTS MA (OWNER/DIRECTOR)
(802) 388-3887
Entity
Organization
Contact information
Practice address
87 RIVERS BEND RD, NEW HAVEN, VT 05472-1101
(802) 388-3887
Mailing address
87 RIVERS BEND RD, NEW HAVEN, VT 05472-1101
(802) 388-3887
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
0470084103
VT
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
0470084103
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020502
—
VT
Enumeration date
07/12/2012
Last updated
07/12/2012
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