NPI 1447708771

Elcm Manor South Management LLC

Organisation Adult Care Home Facility South Burlington, VT

Practice location

Address: 20 Harbor View Rd, South Burlington, VT 05403-7850
Phone: (802) 863-7897
Fax: (802) 863-9728
Mailing address: 14241 Dallas Pkwy STE 650, Dallas, TX 75254-2953

Authorised official

Name: Paul Boethel
Title: Principal
Phone: (972) 728-8739

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

Other Custodial Care Facility providers in Vermont →

Registry record

NPI: 1447708771
Entity type: Organization
NPI issued: 15 Sep 2016
Record last updated: 15 Sep 2016

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.