| Organization Name: | COUNTRY VILLAGE COMMUNITY CARE HOME INC |
| NPI Number: | 1982818522 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDGAR GREASON (VICE PRESIDENT) |
| Mailing Address: | 99 Atkinson St Bellows Falls |
| State: | VT US |
| Postal Code: | 051011302 |
| Phone Number: | 8024634722 |
| Fax Number: | 8024631986 |
| NPI Enumeration Date: | 05/10/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | 0018 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |