Provider Demographics
NPI:1366584260
Name:THE UNIVERSITY OF VERMONT HEALTH NETWORK HOME HEALTH & HOSPICE, INC.
Entity type:Organization
Organization Name:THE UNIVERSITY OF VERMONT HEALTH NETWORK HOME HEALTH & HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE AND OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MANAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-658-1900
Mailing Address - Street 1:1110 PRIM RD
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-6403
Mailing Address - Country:US
Mailing Address - Phone:802-658-1900
Mailing Address - Fax:802-860-4477
Practice Address - Street 1:1110 PRIM RD
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-6403
Practice Address - Country:US
Practice Address - Phone:802-658-1900
Practice Address - Fax:802-860-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008810Medicaid
VT1008811Medicaid
VT047W191Medicaid
VT047W192Medicaid