Organization
BROWNWAY RESIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA S. GERVAIS (MANAGER)
(802) 933-2315
Entity
Organization
Contact information
Practice address
328 SCHOOL ST, ENOSBURG FALLS, VT 05450-5500
(802) 933-2315
(802) 933-7997
Mailing address
328 SCHOOL ST, ENOSBURG FALLS, VT 05450-5500
(802) 933-2315
(802) 933-7997
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
0118
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047W052
—
VT
05
—
047W106
—
VT
Enumeration date
02/23/2007
Last updated
08/22/2020
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