Organization
COUNTRY VILLAGE COMMUNITY CARE HOME INC
Active
Other names
Washington Elms
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDGAR GREASON (VICE PRESIDENT)
(802) 463-4722
Entity
Organization
Contact information
Practice address
99 ATKINSON ST, BELLOWS FALLS, VT 05101-1302
(802) 463-4722
(802) 463-1986
Mailing address
99 ATKINSON ST, PO BOX 468, BELLOWS FALLS, VT 05101-1302
(802) 463-4722
(802) 463-1986
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
0018
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047W140
—
VT
05
—
047W189
—
VT
Enumeration date
05/10/2007
Last updated
08/22/2020
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