Organization
BRATTLEBORO RETREAT
Active
Other names
Linden Street Residential
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY POTTER (SUPERVISOR)
(802) 258-6885
Entity
Organization
Contact information
Practice address
24 LINDEN STREET, BRATTLEBORO, VT 05302
(802) 257-7785
Mailing address
24 LINDEN STREET, BRATTLEBORO, VT 05302
(802) 257-7785
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004215
—
VT
Enumeration date
06/18/2019
Last updated
06/18/2019
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