Provider Demographics
NPI:1558938977
Name:EASTVIEW AT MIDDLEBURY, INC
Entity Type:Organization
Organization Name:EASTVIEW AT MIDDLEBURY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR & CEO
Authorized Official - Prefix:
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-989-7509
Mailing Address - Street 1:100 EASTVIEW TER
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-9327
Mailing Address - Country:US
Mailing Address - Phone:802-989-7500
Mailing Address - Fax:802-989-7265
Practice Address - Street 1:100 EASTVIEW TER
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-9327
Practice Address - Country:US
Practice Address - Phone:802-989-7500
Practice Address - Fax:802-989-7265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility