| Milldale Farm Center For Wellness Plc | |
|
1461 Blood Brook Rd Fairlee VT 05045-9847 | |
| (802) 299-1467 | |
| Not Available |
| Full Name | Milldale Farm Center For Wellness Plc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1461 Blood Brook Rd, Fairlee, Vermont |
| Authorized Official Name and Position | Wesley Wolter (OWNER) |
| Authorized Official Contact | 8022991467 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Milldale Farm Center For Wellness Plc 1461 Blood Brook Rd Fairlee VT 05045-9847 Ph: () - | Milldale Farm Center For Wellness Plc 1461 Blood Brook Rd Fairlee VT 05045-9847 Ph: (802) 299-1467 |
| NPI Number | 1508571043 |
|---|---|
| Provider Enumeration Date | 01/19/2023 |
| Last Update Date | 01/19/2023 |
| Certification Date | 01/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508571043 | NPI | - | NPPES |
| 1417420290 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |