1417121856 NPI number — HOWARDCENTER

Table of content: (NPI 1417121856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417121856 NPI number — HOWARDCENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOWARDCENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417121856
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
208 FLYNN AVE
Provider Second Line Business Mailing Address:
SUTIE 3J
Provider Business Mailing Address City Name:
BURLINGTON
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05401-5429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-488-6920
Provider Business Mailing Address Fax Number:
802-488-6901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 FLYNN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURLINGTON
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05401-5301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-488-6920
Provider Business Practice Location Address Fax Number:
802-488-6901
Provider Enumeration Date:
04/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MCGUIRE
Authorized Official First Name:
SANDY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, FINANCE AND ADMIN
Authorized Official Telephone Number:
802-488-6900

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1006429 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com