Provider Demographics
NPI:1972638138
Name:RIVERBEND RESIDENTIAL CARE HOME
Entity Type:Organization
Organization Name:RIVERBEND RESIDENTIAL CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-685-2250
Mailing Address - Street 1:307 VT RTE 110
Mailing Address - Street 2:PO BOX 7
Mailing Address - City:CHELSEA
Mailing Address - State:VT
Mailing Address - Zip Code:05038-0007
Mailing Address - Country:US
Mailing Address - Phone:802-685-2250
Mailing Address - Fax:802-685-2255
Practice Address - Street 1:307 VT RTE 110
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:VT
Practice Address - Zip Code:05038-8994
Practice Address - Country:US
Practice Address - Phone:802-685-2250
Practice Address - Fax:802-685-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility