Provider Demographics
NPI:1275653081
Name:ADDISON COUNTY HOME HEALTH AND HOSPICE, INC
Entity Type:Organization
Organization Name:ADDISON COUNTY HOME HEALTH AND HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-388-7259
Mailing Address - Street 1:PO BOX 754
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-0754
Mailing Address - Country:US
Mailing Address - Phone:802-388-7259
Mailing Address - Fax:802-388-6126
Practice Address - Street 1:254 ETHAN ALLEN HIGHWAY
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:VT
Practice Address - Zip Code:05472
Practice Address - Country:US
Practice Address - Phone:802-388-7259
Practice Address - Fax:802-388-6126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1004789Medicaid