Organization
IDA'S HOUSE OF VERMONT PROFESSIONAL LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TINEY RAY PHD, DNP, FNP,PMHNP (OWNER)
(678) 701-4679
Entity
Organization
Contact information
Practice address
360 NEW RD, BRANDON, VT 05733-8396
(802) 247-0381
(888) 502-6598
Mailing address
360 NEW RD, BRANDON, VT 05733-8396
(802) 247-0381
(888) 502-6598
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
05/02/2026
Last updated
05/02/2026
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