Provider Demographics
NPI:1497885107
Name:NFI VERMONT, INC
Entity Type:Organization
Organization Name:NFI VERMONT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:802-658-0040
Mailing Address - Street 1:30 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6432
Mailing Address - Country:US
Mailing Address - Phone:802-658-0040
Mailing Address - Fax:802-658-0216
Practice Address - Street 1:30 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6432
Practice Address - Country:US
Practice Address - Phone:802-658-0040
Practice Address - Fax:802-658-0216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Not Answered261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Not Answered261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Not Answered320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Not Answered323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1004136Medicaid
VT1007658Medicaid
VT00068960OtherBC-BS PROVIDER ID#
VT00068969OtherBC-BS PROVIDER ID#
VT1011116Medicaid
VT1004944Medicaid
VT960839OtherMVP PROVIDER ID#
VT6030011Medicaid