Davis Home

LBN: State Street Enterprise, Llc
Davis Home is an health care organization with primary practice located at 45 State St , Windsor VT 05089-1213. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. State Street Enterprise, Llc can be contacted via phone (802) 674-5300, or through Patch, Carrie J via phone (802) 674-5300.

Contact Information

Primary practice address
45 State St Windsor VT 05089-1213
Phone: (802) 674-5300
Fax: (802) 674-5388
Website:
Map and Directions
Authorized official contact:
Name: Patch, Carrie J
Phone: (802) 674-5300

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 0021 Vermont

Profile Details

NPI number 1922130236
LBN Legal business name State Street Enterprise, Llc
DBA Doing business as Davis Home
Authorized official Patch, Carrie J
Entity Organization
Organization subpart 1 No
Enumeration date Mar 12th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922130236 NPPES
Vermont MEDICAID 047W175
Vermont MEDICAID 047W179

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