Provider Demographics
NPI:1053430249
Name:RUTLAND AREA VISITING NURSE ASSOC & HOSPICE
Entity type:Organization
Organization Name:RUTLAND AREA VISITING NURSE ASSOC & HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:C
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-770-1515
Mailing Address - Street 1:7 ALBERT CREE DR
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4601
Mailing Address - Country:US
Mailing Address - Phone:802-770-1515
Mailing Address - Fax:802-775-2304
Practice Address - Street 1:7 ALBERT CREE DR
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4601
Practice Address - Country:US
Practice Address - Phone:802-770-1515
Practice Address - Fax:802-775-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1004869251B00000X
VT1005274251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1004869Medicaid
VT1005274Medicaid