NPIMap

Organization Active NPI

Holton Home, Inc.

  • Custodial Care Facility
  • Brattleboro, VT
National Provider Identifier
1457497372
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
48 Issued in VT
Legal business name
HOLTON HOME, INC.
Practice address
158 Western Ave
Brattleboro, VT 05301-6089
Phone
(802) 254-4155
Fax
(802) 254-1349
NPI assigned
Jan 29, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Cindy Jerome
Title
Administrator
Phone
(802) 254-4155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X 48 VT Primary

Addresses

Primary practice location

158 Western Ave
Brattleboro, VT 05301-6089

Mailing address

158 Western Ave
Brattleboro, VT 05301-6089
Phone (802) 254-4155

Other identifiers 3

IdentifierTypeStateIssuer
047R020MedicaidVT
047W043MedicaidVT
047W123MedicaidVT

National Provider Directory

National Provider Directory
Tax ID family
Holton Home Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

158 Western Ave
Brattleboro, VT 05301
Phone (802) 254-4155

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457497372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 WESTERN AVE",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016089",
            "telephone_number": "802-254-4155",
            "fax_number": "802-254-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 WESTERN AVE",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016089",
            "telephone_number": "802-254-4155",
            "fax_number": "802-254-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLTON HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JEROME",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "802-254-4155"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "VT",
            "license": "48",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047R020",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W043",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W123",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.