Provider Demographics
NPI:1235261009
Name:RUTLAND MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:RUTLAND MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR AR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-775-8224
Mailing Address - Street 1:78 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4530
Mailing Address - Country:US
Mailing Address - Phone:802-775-8224
Mailing Address - Fax:802-747-7699
Practice Address - Street 1:78 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4530
Practice Address - Country:US
Practice Address - Phone:802-775-8224
Practice Address - Fax:802-747-7699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Not Answered261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Not Answered261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT6040018Medicaid
VT1007353Medicaid
VT6030007Medicaid