47D2203543 CLIA NUMBER - MANSFIELD PLACE ASSISTED LIVING

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Laboratory Demographics

CLIA Number: 47D2203543

Facility Name: MANSFIELD PLACE ASSISTED LIVING

Facility Address:
18 CARMICHAEL STREET
ESSEX JUNCTION, VT
ZIP 05452
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Facility Phone Number: 802 662-2410

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1356755102

Taxonomy: 3104A0630X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors.

CLIA Record

Field Name	Field Value
CLIA Number	47D2203543
LAB Type	Assisted Living Facility
Facility Name	MANSFIELD PLACE ASSISTED LIVING
Street	18 CARMICHAEL STREET
City	ESSEX JUNCTION
State	VT
ZIP	05452
Phone	802 662-2410
CertificateType	4
CertificateEffectiveDate	12/4/2022
CertificateExpirationDate	12/3/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024