47 Main Street Corporation
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Castleton, VT
NPI 1134465784 · NPPES record last updated Dec 28, 2012
Key facts
- NPI
- 1134465784
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- Legal business name
- 47 MAIN STREET CORPORATION
- Practice address
- 706 Main Street
Castleton, VT 05735-0038 - Phone
- (800) 287-5325
- Fax
- (802) 468-5152
- NPI assigned
- Dec 28, 2012
- Organization subpart
- No
Authorized official
- Name
- Willem Leenman, MHSA
- Title
- Director
- Phone
- (802) 468-5325
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Yes |
Addresses
Primary practice location
706 Main Street
Castleton, VT 05735-0038
Mailing address
PO Box 38
706 Main Street
Castleton, VT 05735-0038
Phone (800) 287-5325
Other names
- Fortyseven Main Street, Inc
Other providers in Castleton, VT
All providers in Castleton, VT · Mental Illness Community Based Residential Treatment Facility in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.