Provider Demographics
NPI:1568000552
Name:WOODSTOCK AREA ADULT DAY SERVICES, INC
Entity Type:Organization
Organization Name:WOODSTOCK AREA ADULT DAY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-280-2860
Mailing Address - Street 1:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VT
Mailing Address - Zip Code:05091-0180
Mailing Address - Country:US
Mailing Address - Phone:802-280-6080
Mailing Address - Fax:802-280-6079
Practice Address - Street 1:8826 WOODSTOCK ROAD
Practice Address - Street 2:
Practice Address - City:QUECHEE
Practice Address - State:VT
Practice Address - Zip Code:05059
Practice Address - Country:US
Practice Address - Phone:802-280-6080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT047W409Medicaid