Basic Information
| Provider Information | |||||||||
| NPI: | 1770940462 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOWARDCENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 208 FLYNN AVE | ||||||||
| Address2: | SUITE 3J | ||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054015429 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1138 PINE ST | ||||||||
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| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054015353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8024886600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2016 | ||||||||
| LastUpdateDate: | 01/26/2016 | ||||||||
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| AuthorizedOfficialLastName: | BRUNELL | ||||||||
| AuthorizedOfficialFirstName: | ELIZABETH | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8024886934 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.