Provider Demographics
NPI:1366832230
Name:GIFFORD RETIREMENT COMMUNITY, INC
Entity Type:Organization
Organization Name:GIFFORD RETIREMENT COMMUNITY, INC
Other - Org Name:MENIG NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-728-2356
Mailing Address - Street 1:44 S MAIN ST
Mailing Address - Street 2:PO BOX 2000
Mailing Address - City:RANDOLPH
Mailing Address - State:VT
Mailing Address - Zip Code:05060-1381
Mailing Address - Country:US
Mailing Address - Phone:802-728-7000
Mailing Address - Fax:802-728-2143
Practice Address - Street 1:3556 RT 66
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:VT
Practice Address - Zip Code:05060-1318
Practice Address - Country:US
Practice Address - Phone:802-728-2125
Practice Address - Fax:802-728-2143
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GIFFORD RETIREMENT COMMUNITY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility