| Organization Name: | TRUSTEES OF THE GILL ODD FELLOWS HOME OF VERMONT |
| NPI Number: | 1417958356 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THERESA C. SOUTHWORTH (NURSING HOME ADMINISTRATOR) |
| Mailing Address: | 8 Gill Ter Ludlow |
| State: | VT US |
| Postal Code: | 051491004 |
| Phone Number: | 8022284571 |
| Fax Number: | 8022282229 |
| NPI Enumeration Date: | 08/02/2005 |
| NPI Last Update Date: | 05/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VT |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |