Organization
UNITED COUNSELING SERVICE OF BENNINGTON COUNTY, INC.
Active
Organization
UNITED COUNSELING SERVICE OF BENNINGTON COUNTY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH J PROVENZA (EXECUTIVE DIRECTOR)
(802) 442-5491
Entity
Organization
Contact information
Practice address
100 LEDGEHILL RD, BENNINGTON, VT 05201-2273
(802) 442-5491
Mailing address
PO BOX 588, BENNINGTON, VT 05201-0588
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6060013
—
VT
Enumeration date
02/28/2007
Last updated
03/14/2008
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