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NPI Code Detail

MEDICARE: LUND FAMILY CENTER

MEDICARE: LUND FAMILY CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility
2324500000XSubstance Abuse Rehabilitation Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851410401
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUND FAMILY CENTER
Provider Business Mailing Address
First Line : PO BOX 4009
Second Line :
City : BURLINGTON
State : VT
Zip : 05406-4009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 76 GLEN RD
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-4131
Country : US
Telephone Number : 802-864-7467
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : BARBARA RACHELSON
Credential :
Telephone Number : 802-864-7467
Provider Enumeration Date : 03/28/2007
Last Update Date : 01/22/2008

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1255822391 — THE LUND FAMILY CENTER
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Directions to “LUND FAMILY CENTER ” Practice Location

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