NPI 1134465784
47 Main Street Corporation
Practice location
- Address
- 706 Main Street, Castleton, VT 05735-0038
- Phone
- (800) 287-5325
- Fax
- (802) 468-5152
- Mailing address
- PO Box 38 706 Main Street, Castleton, VT 05735-0038
Authorised official
- Name
- Willem Leenman
- Title
- Director
- Phone
- (802) 468-5325
Registered specialties
Mental Illness Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1134465784
- Entity type
- Organization
- NPI issued
- 28 Dec 2012
- Record last updated
- 28 Dec 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.