Organization
NORTH COUNTRY HEALTH SERVICES INC
Active
Other names
Derby Green
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA ANN BOHLMAN RN BSN CCM (ADMINISTRATOR)
(802) 766-2126
Entity
Organization
Contact information
Practice address
2853 US ROUTE 5, DERBY, VT 05829-9629
(802) 766-2201
(802) 766-2031
Mailing address
PO BOX 24, 2853 US RTE 5, DERBY, VT 05829-0024
(802) 766-2201
(802) 766-2031
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
47E054
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
475048
—
VT
Enumeration date
09/06/2005
Last updated
08/22/2020
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