Country Village Community Care Home Inc

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

0018 Issued in VT

Legal business name

COUNTRY VILLAGE COMMUNITY CARE HOME INC

Practice address

99 Atkinson St
Bellows Falls, VT 05101-1302

Phone

(802) 463-4722

Fax

(802) 463-1986

NPI assigned

May 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Edgar Greason

Title

Vice President

Phone

(802) 463-4722

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Washington Elms Other name

Locations

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982818522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 ATKINSON ST",
            "address_2": "PO BOX 468",
            "city": "BELLOWS FALLS",
            "state": "VT",
            "postal_code": "051011302",
            "telephone_number": "802-463-4722",
            "fax_number": "802-463-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 ATKINSON ST",
            "city": "BELLOWS FALLS",
            "state": "VT",
            "postal_code": "051011302",
            "telephone_number": "802-463-4722",
            "fax_number": "802-463-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY VILLAGE COMMUNITY CARE HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREASON",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "802-463-4722",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "VT",
            "license": "0018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W189",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W140",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Elms",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rebecca Chrisinger, BA
• Gary A Clay, MD
• Margaret Comparetta, LMFT
• Marc Peter Cote, R.PH.
• Sandra A Cotter, LCMHC, MLADC
• Jessica Day
• Dr. David M. Heydenreich
• Dr. Vernon R. Temple
• Holiday Eames, LCMHC, NCC
• Fall Mountain Pharmacy, LLC

• Public Health or Welfare Agency in Bellows Falls, VT
• Providers in Bellows Falls, VT by specialty
• Public Health or Welfare Agency 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.