NPIMap

Organization Active NPI

Health Care and Rehabilitation Services of Southeastern Vermont, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bellows Falls, VT
National Provider Identifier
1114144565
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
HEALTH CARE AND REHABILITATION SERVICES OF SOUTHEASTERN VERMONT, INC.
Practice address
1 Hospital CT
Suite 410
Bellows Falls, VT 05101-1489
Phone
(802) 463-3294
Fax
(802) 463-1206
NPI assigned
Apr 19, 2007
Last updated
Nov 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edmund H Moore
Title
Cfo
Phone
(802) 886-4567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

1 Hospital CT
Suite 410
Bellows Falls, VT 05101-1489

Mailing address

390 River St
Springfield, VT 05156-2226
Phone (802) 886-4500

Other identifiers 1

IdentifierTypeStateIssuer
1001793MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040819001433 VT Part B Supplier - Clinic/Group Practice 4183698830 Receives reassigned benefits from 39 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellows Falls, VT; Brattleboro, VT; Hartford, VT; Newfane, VT; Springfield, VT; White River Junction, VT; Windsor, VT

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Health Care and Rehabilitation Services of Southeastern Vermont Inc22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1114144565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 RIVER ST",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051562226",
            "telephone_number": "802-886-4500",
            "fax_number": "802-886-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL CT",
            "address_2": "SUITE 410",
            "city": "BELLOWS FALLS",
            "state": "VT",
            "postal_code": "051011489",
            "telephone_number": "802-463-3294",
            "fax_number": "802-463-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CARE AND REHABILITATION SERVICES OF SOUTHEASTERN VERMONT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "802-886-4567"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001793",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellows Falls, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.