Provider Demographics
NPI:1861488520
Name:MERTEN'S HOUSE
Entity type:Organization
Organization Name:MERTEN'S HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM.
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-457-4411
Mailing Address - Street 1:73 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VT
Mailing Address - Zip Code:05091-1226
Mailing Address - Country:US
Mailing Address - Phone:802-457-4411
Mailing Address - Fax:802-457-5722
Practice Address - Street 1:73 RIVER ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VT
Practice Address - Zip Code:05091-1226
Practice Address - Country:US
Practice Address - Phone:802-457-4411
Practice Address - Fax:802-457-5722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT47S002313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility