Provider Demographics
NPI:1790810786
Name:PILLSBURY ASSOCIATES, INC
Entity Type:Organization
Organization Name:PILLSBURY ASSOCIATES, INC
Other - Org Name:PILLSBURY MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:SPALDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-863-7897
Mailing Address - Street 1:20 HARBOR VIEW RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7850
Mailing Address - Country:US
Mailing Address - Phone:802-863-7897
Mailing Address - Fax:802-863-9728
Practice Address - Street 1:20 HARBOR VIEW RD
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7850
Practice Address - Country:US
Practice Address - Phone:802-863-7897
Practice Address - Fax:802-863-9728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0149311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT047W250Medicaid
VT047W260Medicaid
VT047W254Medicaid
VT047W146Medicaid
VT047W046Medicaid
VT047W259Medicaid