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NPI Code Detail

MEDICARE: THE LUND FAMILY CENTER

MEDICARE: THE 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
1320800000XMental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1255822391
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE 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 : 802-864-7467
Fax Number : 802-864-1619
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 : 802-864-1619
Authorized Official
Title or Position : CASE MANAGEMENT COORDINATOR
Name : AMY S WOODRUFF
Credential : LCMHC, LADC
Telephone Number : 802-448-3618
Provider Enumeration Date : 05/24/2018
Last Update Date : 05/24/2018

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Directions to “THE LUND FAMILY CENTER ” Practice Location

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