Organization
NORTHERN COUNTIES HEALTH CARE, INC.
Active
Other names
Caledonia Home Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK DONNELLY (INTERIM EXECUTIVE DIRECTOR)
(802) 748-9405
Entity
Organization
Contact information
Practice address
161 SHERMAN DRIVE, ST. JOHNSBURY, VT 05819
(802) 748-8116
(802) 748-4628
Mailing address
161 SHERMAN DRIVE, ST. JOHNSBURY, VT 05819
(802) 748-8116
(802) 748-4628
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004923
—
VT
05
—
1005008
—
VT
05
—
1005248
—
VT
05
—
1005275
—
VT
05
—
47-W004
—
VT
01
—
T001703
CHAMPUS-HOSPICE
VT
Enumeration date
03/19/2007
Last updated
08/22/2020
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