Provider Demographics
NPI:1588666754
Name:CEDAR HILL HEALTH CARE CORPORATION
Entity Type:Organization
Organization Name:CEDAR HILL HEALTH CARE CORPORATION
Other - Org Name:VICTORIAN HOUSE RESIDENCE AT CEDAR HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SAYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-674-6609
Mailing Address - Street 1:49 CEDAR HILL DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:VT
Mailing Address - Zip Code:05089-9470
Mailing Address - Country:US
Mailing Address - Phone:802-674-6609
Mailing Address - Fax:802-674-5618
Practice Address - Street 1:49 CEDAR HILL DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:VT
Practice Address - Zip Code:05089-9470
Practice Address - Country:US
Practice Address - Phone:802-674-6609
Practice Address - Fax:802-674-5618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT475046313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT475046Medicare ID - Type Unspecified