Provider Demographics
NPI:1164238291
Name:LONG LIFE CARE OF VERMONT LLC
Entity type:Organization
Organization Name:LONG LIFE CARE OF VERMONT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NEUVIC
Authorized Official - Middle Name:KALMAR
Authorized Official - Last Name:MALEMBANIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-399-7787
Mailing Address - Street 1:34 CANADA ST
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:VT
Mailing Address - Zip Code:05488-1041
Mailing Address - Country:US
Mailing Address - Phone:802-399-7787
Mailing Address - Fax:
Practice Address - Street 1:34 CANADA ST
Practice Address - Street 2:
Practice Address - City:SWANTON
Practice Address - State:VT
Practice Address - Zip Code:05488-1041
Practice Address - Country:US
Practice Address - Phone:802-399-7787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty