MEDICARE: SPRINGFIELD AREA PARENT CHILD 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
1	251K00000X	Public Health or Welfare Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1114097375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRINGFIELD AREA PARENT CHILD CENTER

Provider Business Mailing Address
First Line	:	2 MAIN ST
Second Line	:
City	:	NORTH SPRINGFIELD
State	:	VT
Zip	:	05150-9739
Country	:	US
Telephone Number	:	802-886-5242
Fax Number	:	802-886-2007

Provider Business Practice Location Address
First Line	:	2 MAIN ST
Second Line	:
City	:	NORTH SPRINGFIELD
State	:	VT
Zip	:	05150-9739
Country	:	US
Telephone Number	:	802-886-5242
Fax Number	:	802-886-2007

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	BETTY KINSMAN
Credential	:
Telephone Number	:	802-886-5242

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	09/20/2010

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