Provider Demographics
NPI:1104881713
Name:VERMONT ASSOCIATION FOR THE BLIND
Entity type:Organization
Organization Name:VERMONT ASSOCIATION FOR THE BLIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:POULIOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-863-1358
Mailing Address - Street 1:60 KIMBALL AVE
Mailing Address - Street 2:
Mailing Address - City:S BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6808
Mailing Address - Country:US
Mailing Address - Phone:802-863-1358
Mailing Address - Fax:802-863-1481
Practice Address - Street 1:60 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:S BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6808
Practice Address - Country:US
Practice Address - Phone:802-863-1358
Practice Address - Fax:802-863-1481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1006536Medicaid