Basic Information
| Provider Information | |||||||||
| NPI: | 1134346687 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOWARDCENTER INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 208 FLYNN AVE STE 3J | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054015420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8024886900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 855 PINE ST | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054014924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8024886920 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2007 | ||||||||
| LastUpdateDate: | 05/07/2021 | ||||||||
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| AuthorizedOfficialLastName: | MCGUIRE | ||||||||
| AuthorizedOfficialFirstName: | SANDY | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF ADMIN AND FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 8024886900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | VT | N | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | 261QM2800X | Y | Ambulatory Health Care Facilities | Clinic/Center | Methadone Clinic |
ID Information
| ID | Type | State | Issuer | Description | 1009456 | 05 | VT | MEDICAID | 1006439 | 05 | VT | MEDICAID |