Vermont Catholic Charities, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

0143 Issued in VT

Legal business name

VERMONT CATHOLIC CHARITIES, INC.

Doing business as

Michaud Memorial Manor

Practice address

47 Herrick Road
Derby Line, VT 05830-8759

Phone

(802) 873-3152

Fax

(802) 864-7297

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Denise M Payea

Title

Business Manager

Phone

(802) 658-6111

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Michaud Memorial Manor Doing business as

Tax ID family

Vermont Catholic Charities Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Vermont Catholic Charities, Inc

  • Voluntary or Charitable Agency
  • Rutland, VT
  • NPI 1265538573
  NPD tax ID
• Vermont Catholic Charities, Inc

  • Voluntary or Charitable Agency
  • South Burlington, VT
  • NPI 1811068661
  NPD tax ID
• Vermont Catholic Charities, Inc.

  dba St. Joseph's Home

  • Adult Care Home Facility
  • Burlington, VT
  • NPI 1952412017
  NPD tax ID

Locations

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1518078666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 JOY DRIVE",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054030000",
            "telephone_number": "802-658-6111",
            "fax_number": "802-860-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 HERRICK ROAD",
            "city": "DERBY LINE",
            "state": "VT",
            "postal_code": "058308759",
            "telephone_number": "802-873-3152",
            "fax_number": "802-864-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMONT CATHOLIC CHARITIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "PAYEA",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "802-658-6111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "VT",
            "license": "0143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W058",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W096",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michaud Memorial Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Browns Drug Store
• Catherine Anne Clark, LCMHC
• Myra Gene Ann Degre, PT, DPT
• Derby Line Ambulance
• Miriam Blodgett Tatum, M.D.
• Cameron Ward, LMSW

• Adult Care Home Facility in Derby Line, VT
• Providers in Derby Line, VT by specialty
• Adult Care Home Facility in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.