Organization
OUR LADY OF PROVIDENCE VT. INC.
Active
Other names
OurLady of Providence
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN PROULX (SISTER)
(802) 655-2395
Entity
Organization
Contact information
Practice address
47 W SPRING ST, WINOOSKI, VT 05404-1319
(802) 655-2395
Mailing address
47 W SPRING ST, WINOOSKI, VT 05404-1319
(802) 655-2395
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
0198
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047W152
—
VT
05
—
047W267
—
VT
Enumeration date
02/22/2007
Last updated
08/22/2020
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