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General NPI Number Information
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NPI Number | 1629700497
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Entity Type | Organization
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Legal Business Name | NORTH EAST KINGDOM COMMUNITY ACTION, INC.
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 115 LINCOLN ST
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City | ST JOHNSBURY
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State | VT
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Zip | 05819-2449
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Country | US
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Telephone | 802-748-6040
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 346
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City | NEWPORT
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State | VT
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Zip | 05855-0346
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Country | US
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Telephone | 803-424-2797
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Fax |
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Authorized Official
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Title or Position | ACCOUNTING MANAGER
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Name | SALLY DEVAN
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Credential |
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Telephone | 802-424-2797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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