Provider Demographics
NPI:1891918918
Name:DEBORAH I HODGE
Entity Type:Organization
Organization Name:DEBORAH I HODGE
Other - Org Name:VALLEY VIEW HOME FOR THE RETIRED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:I
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-333-4829
Mailing Address - Street 1:69 OAK LANE
Mailing Address - Street 2:
Mailing Address - City:FAIRLEE
Mailing Address - State:VT
Mailing Address - Zip Code:05045
Mailing Address - Country:US
Mailing Address - Phone:802-333-4829
Mailing Address - Fax:802-333-7091
Practice Address - Street 1:69 OAK LANE
Practice Address - Street 2:
Practice Address - City:FAIRLEE
Practice Address - State:VT
Practice Address - Zip Code:05045
Practice Address - Country:US
Practice Address - Phone:802-333-4829
Practice Address - Fax:802-333-7091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0195374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT047W073Medicaid
VT047W087Medicaid