Windover House INC
Custodial Care Facility, Adult Care Home in Randolph, VT. Organization (NPI-2).
NPI number1154446367
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1154446367
- Entity type
- Organization (NPI-2)
- Legal business name
- Windover House INC
- Organization subpart
- No
- Enumeration date
- Mar 20, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | 0109 | VT | Yes |
Practice location
451 Vt Route 66Randolph, VT 05060-9387
Phone 802-728-3802
Mailing address
451 Vt Route 66Randolph, VT 05060-9387
Phone 802-728-3802
Authorized official
Donald L Jacobs
President
8027283802
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