Provider Demographics
NPI:1962826610
Name:VERMONT HEALTHCARE, LLC
Entity Type:Organization
Organization Name:VERMONT HEALTHCARE, LLC
Other - Org Name:BELLS REST HOME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:MR
Authorized Official - First Name:ELPIDIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAGALOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-835-3632
Mailing Address - Street 1:865 VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-2120
Mailing Address - Country:US
Mailing Address - Phone:510-835-3632
Mailing Address - Fax:
Practice Address - Street 1:865 VERMONT ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-2120
Practice Address - Country:US
Practice Address - Phone:510-835-3632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA015600938311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home