47 MAIN STREET CORPORATION (NPI# 1134465784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134465784 |
| Entity Type | Organization |
| Organization Name | 47 MAIN STREET CORPORATION |
| Other Organization Name | FORTYSEVEN MAIN STREET, INC |
| Practice Address |
706 Main Street Castleton VT 05735-0038 |
| Mailing Address |
Po Box 38 706 Main Street Castleton VT 05735-0038 |
| Practice Telephone | 8002875325 |
| Practice Fax Number | 8024685152 |
| Mailing Telephone | 8002875325 |
| Mailing Fax Number | 8024685152 |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2012-12-28 |
| Authorized Official Name | WILLEM LEENMAN (DIRECTOR) |
| Authorized Official Telephone | 8024685325 |
| Authorized Official Credential | MHSA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Fortyseven Main Street, Inc | Doing Business As Name - Organization |
| Street Address |
706 MAIN STREET |
| City | CASTLETON |
| State | VT |
| Zip Code | 05735-0038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548775083 | Kate Elizabeth Steller | Student in an Organized Health Care Education/Training Program | 190 University Drive, Castleton, VT 05735 | 2017-12-06 |
| 1356771976 | Heather Elizabeth Fjeld Nelson | Speech-Language Pathologist | 263 Elementary School Road, Castleton, VT 05735 | 2013-11-18 |
| 1669764650 | Kelley Odorisio | Physical Therapist | 218 Route 4a W, Castleton, VT 05735 | 2011-05-09 |
| 1881901825 | Sunset House - Birdseye, Inc. | Substance Abuse Rehabilitation Facility | 511 Sand Hill Road, Castleton, VT 05735 | 2010-09-13 |
| 1003942038 | Cerise Marie Barber | Specialist/Technologist | Castleton State College, Glenbrook Gym, Castleton, VT 05735 | 2007-02-26 |
| 1457422941 | James Evans Wright | Dentist | 1939 Route 4a, Castleton, VT 05735 | 2006-11-13 |
| 1083620017 | Michael Patrick Finnegan | Physical Therapist | 218b Rt 4a West, Slate Valley Physical Therapy, Castleton, VT 05735 | 2006-07-31 |
| 1043286131 | Elly R. Ventura | Specialist/Technologist | 190 College Drive, Glenbrook Gym, Castleton, VT 05735 | 2006-02-27 |
| 1013245307 | Slate Valley Physical Therapy, Inc. | Physical Therapist | 218 B Route 4a West, Castleton, VT 05735-0218 | 2009-11-24 |
| 1265572010 | David Don Hassebroek | Dentist | Rt. 30 Castleton Four Corners, Castleton, VT 05735-0417 | 2007-02-08 |
| Find all providers in zip 05735 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346759677 | Path At Stone Summit | Community Based Residential Treatment Facility, Mental Illness | 2380 Colvin Hill Rd, Danby, VT 05739-9549 | 2017-09-29 |
| 1427596360 | Confluence Behavioral Health LLC | Community Based Residential Treatment Facility, Mental Illness | 1646 Gove Hill Rd, Thetford Center, VT 05075-9041 | 2017-02-10 |
| 1093116071 | Phoenix House - Tapestry | Community Based Residential Treatment Facility, Mental Illness | 178 Linden St, Brattleboro, VT 05301-2855 | 2014-09-10 |
| 1518394212 | State of Vermont | Community Based Residential Treatment Facility, Mental Illness | 1076 Us Rte 2, Middlesex, VT 05633-7801 | 2013-09-26 |
| 1033488036 | Hundred Acre Homestead | Community Based Residential Treatment Facility, Mental Illness | 171 Gould Hill Rd, Worcester, VT 05682-9795 | 2011-12-20 |
| 1780913020 | True North Wilderness Programs | Community Based Residential Treatment Facility, Mental Illness | 5354 Main St, Waitsfield, VT 05673 | 2009-12-16 |
| 1356434831 | Eagle Eye Farm Rehabilitation Center | Community Based Residential Treatment Facility, Mental Illness | 3014 Abbott Hill Road, Newark, VT 05871 | 2006-10-02 |
| 1255822391 | The Lund Family Center | Community Based Residential Treatment Facility, Mental Illness | 76 Glen Rd, Burlington, VT 05401-4131 | 2018-05-24 |
| 1952528408 | Howardcenter Inc. | Community Based Residential Treatment Facility, Mental Illness | 1138 Pine St, Burlington, VT 05401-5353 | 2007-04-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.