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Organization

THE TRUSTEES OF THE GILL ODD FELLOWS HOME OF VERMONT

Active
Other names
GILL ODD FELLOWS HOME
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. THERESA C. SOUTHWORTH NURSING HOME ADMINIS (NURSING HOME ADMINISTRATOR)
(802) 228-4571
Entity
Organization

Contact information

Practice address
8 GILL TER, LUDLOW, VT 05149-1004
(802) 228-4571
(802) 228-2229
Mailing address
8 GILL TERRACE, LUDLOW, VT 05149
(802) 228-4571
(802) 228-2229

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
385H00000X
Respite Care
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
047-5052
VT
01
047R008
RESPITE PROVIDER#
VT
Enumeration date
08/02/2005
Last updated
09/06/2023
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