Craftsbury Community Care Center, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

0292 Issued in VT

Legal business name

CRAFTSBURY COMMUNITY CARE CENTER, INC.

Practice address

1784 E Craftsbury Rd
Craftsbury, VT 05826-9519

Phone

(802) 586-2414

Fax

(802) 586-6956

NPI assigned

Mar 26, 2007

Organization subpart

No

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

Authorized official

Name

Lance W. Comfort

Title

Executive Director

Phone

(802) 586-2414

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528185360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1784 E CRAFTSBURY RD",
            "city": "CRAFTSBURY",
            "state": "VT",
            "postal_code": "058269519",
            "telephone_number": "802-586-2414",
            "fax_number": "802-586-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1784 E CRAFTSBURY RD",
            "city": "CRAFTSBURY",
            "state": "VT",
            "postal_code": "058269519",
            "telephone_number": "802-586-2414",
            "fax_number": "802-586-6956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAFTSBURY COMMUNITY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COMFORT",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "802-586-2414"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "VT",
            "license": "0292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W090",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Craftsbury, VT
• Providers in Craftsbury, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.