Provider Demographics
NPI:1114097375
Name:SPRINGFIELD AREA PARENT CHILD CENTER
Entity Type:Organization
Organization Name:SPRINGFIELD AREA PARENT CHILD CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:KINSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-886-5242
Mailing Address - Street 1:2 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05150-9739
Mailing Address - Country:US
Mailing Address - Phone:802-886-5242
Mailing Address - Fax:802-886-2007
Practice Address - Street 1:2 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05150-9739
Practice Address - Country:US
Practice Address - Phone:802-886-5242
Practice Address - Fax:802-886-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1004793Medicaid