Misty Heather Morn Community Care Home
Organization Active NPI Custodial Care Facility · Hydeville, VT
NPI 1629285697 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1629285697
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Custodial Care Facility 311Z00000X
- License
- 0174 (VT)
- Legal business name
- MISTY HEATHER MORN COMMUNITY CARE HOME
- Practice address
- 174 Blissville Rd
Hydeville, VT 05750-0176 - Phone
- (802) 265-3300
- Fax
- (802) 265-3300
- NPI assigned
- May 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Francetta Irene Tice, R.N.
- Title
- Owner
- Phone
- (802) 265-3300
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Custodial Care Facility | 311Z00000X | 0174 | VT | Yes |
Addresses
Primary practice location
174 Blissville Rd
Hydeville, VT 05750-0176
Mailing address
PO Box 176
Hydeville, VT 05750-0176
Phone (802) 265-3300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 047W125 | Medicaid | VT | |
| 047W187 | Medicaid | VT |
Other providers in Hydeville, VT
All providers in Hydeville, VT · Custodial Care 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 Aug 22, 2020. 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.