Organization Name: | GREEN MOUNTAIN THERAPEUTIC SERVICES, LLC |
NPI Number: | 1134243637 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCOTT VERZILLI (OWNER) |
Mailing Address: | 65 Portland Street Morrisville |
State: | VT US |
Postal Code: | 05661 |
Phone Number: | 8028888898 |
Fax Number: | 8028882880 |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |