FORTYSEVEN MAIN STREET, INC – NPI #1134465784
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Mental Illness

FORTYSEVEN MAIN STREET, INC is a community based residential treatment facility located in CASTLETON, VT. NPPES has assigned the NPI number 1134465784 to FORTYSEVEN MAIN STREET, INC on December 28, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FORTYSEVEN MAIN STREET, INC” is a dba name, the actual legal business name for this organization is 47 MAIN STREET CORPORATION. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FORTYSEVEN MAIN STREET, INC below.

NPI Profile for
47 MAIN STREET CORPORATION

NPI Number
1134465784
Enumeration Date

(more than 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
47 MAIN STREET CORPORATION
Doing Business As (dba): FORTYSEVEN MAIN STREET, INC
Primary location
706 MAIN STREET
CASTLETON, VT 05735-0038
Phone: (800) 287-5325 Fax: (802) 468-5152
Mailing address
PO BOX 38
706 MAIN STREET
CASTLETON, VT 05735-0038
Phone: (800) 287-5325 Fax: (802) 468-5152
Organization Subpart
No
Authorized Official
WILLEM LEENMAN
DIRECTOR
Phone: (802) 468-5325
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.