Organization
HOLTON HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY JEROME (ADMINISTRATOR)
(802) 254-4155
Entity
Organization
Contact information
Practice address
158 WESTERN AVE, BRATTLEBORO, VT 05301-6089
(802) 254-4155
(802) 254-1349
Mailing address
158 WESTERN AVE, BRATTLEBORO, VT 05301-6089
(802) 254-4155
(802) 254-1349
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
48
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047R020
—
VT
05
—
047W043
—
VT
05
—
047W123
—
VT
Enumeration date
01/29/2007
Last updated
08/22/2020
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