Organization
SPRING LAKE RANCH
Active
Organization
SPRING LAKE RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW RICHARDS-PEELLE (BUSINESS MANAGER)
(802) 492-3322
Entity
Organization
Contact information
Practice address
1169 SPRING LAKE RD, CUTTINGSVILLE, VT 05738-4418
(802) 492-3322
(802) 492-3331
Mailing address
1169 SPRING LAKE RD, CUTTINGSVILLE, VT 05738-4418
(802) 492-3322
(802) 492-3331
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
0526
VT
324500000X
Substance Abuse Rehabilitation Facility
0526
VT
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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