Provider Demographics
NPI:1073253811
Name:GARDEN PATH ELDER LIVING, INC.
Entity Type:Organization
Organization Name:GARDEN PATH ELDER LIVING, INC.
Other - Org Name:THE BRADLEY HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SITE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KREE
Authorized Official - Middle Name:
Authorized Official - Last Name:RINFRET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-254-4155
Mailing Address - Street 1:158 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-6089
Mailing Address - Country:US
Mailing Address - Phone:802-254-4155
Mailing Address - Fax:
Practice Address - Street 1:158 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-6089
Practice Address - Country:US
Practice Address - Phone:802-254-4155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARDEN PATH ELDER LIVING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-30
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT701100368Medicaid