Kingdom Therapeutics at Safe Haven Farm, Incorporated

NPI #1609462605 in Derby, Vermont

Provider Information

NPI Number: 1609462605
Entity Type: Organization
Organization Name: Kingdom Therapeutics at Safe Haven Farm, Incorporated
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Dec 15, 2020
Last Updated: Dec 15, 2020

Practice Location

Address: 4095 GORE RD
City: Derby
State: Vermont
ZIP Code: 05829-9408
Phone: (802) 673-6476

Authorized Official

Name: KRISTEN WATSON, LCMHC
Title: CLINICAL MENTAL HEALTH COUNSELOR
Phone: (802) 673-6476

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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