BRATTLEBORO RETREAT NPI 1730185232

NPI Information

NPI: 1730185232
Provider Name: BRATTLEBORO RETREAT
Classification: Psychiatric Hospital - 283Q00000X
Entity Type: Organization

CLIA Number: 47D0090903

Address:
1 ANNA MARSH LANE
BRATTLEBORO, VT
ZIP 05302
Phone: (802) 257-7785
Get Directions

BRATTLEBORO RETREAT is a psychiatric hospital in Brattleboro, VT. The provider is an organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. BRATTLEBORO RETREAT NPI is 1730185232. The provider is registered as an organization entity type.

The provider's business location address is:

1 ANNA MARSH LANE
BRATTLEBORO, VT
ZIP 05302-803
Phone: (802) 257-7785
Fax: (802) 258-3723

The provider's authorized official is Doreen Rancourt .
The authorized official title is Credentialing and has the following contact phone number (802) 258-6956.

The CLIA number assigned to this NPI record is 47D0090903 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/21/2005 and was last updated on 11/2/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			No
2	261QM0850X	Clinic/Center	Adult Mental Health			No
3	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
4	261QM1300X	Clinic/Center	Multi-Specialty			No
5	3336C0002X	Pharmacy	Clinic Pharmacy			No
6	3336I0012X	Pharmacy	Institutional Pharmacy			No
7	283Q00000X	Psychiatric Hospital		649	VERMONT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0474001	MEDICAID	VERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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