Organization Name: | PHOENIX HOUSE - TAPESTRY |
NPI Number: | 1093116071 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD TURNER (VICE PRESIDENT/VERMONT) |
Mailing Address: | 178 Linden St Brattleboro |
State: | VT US |
Postal Code: | 053012855 |
Phone Number: | 8022572415 |
Fax Number: | 8022574617 |
NPI Enumeration Date: | 09/10/2014 |
NPI Last Update Date: | 09/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | 000506 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VT |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |