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NPI Code Detail

MEDICARE: LUND FAMILY CENTER, INC.

MEDICARE: LUND FAMILY CENTER, INC.
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 FacilityVT
2251S00000XCommunity/Behavioral Health AgencyVT

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 : 1770794323
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUND FAMILY CENTER, INC.
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 : DIRECTOR OF OPERATIONS
Name : ROBERT ROBINSON
Credential :
Telephone Number : 802-864-7467
Provider Enumeration Date : 05/25/2007
Last Update Date : 12/05/2014

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