Provider Demographics
NPI:1376119966
Name:LITTLE RIVERS HEALTH CARE, INC.
Entity Type:Organization
Organization Name:LITTLE RIVERS HEALTH CARE, INC.
Other - Org Name:LITTLE RIVERS HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-222-4637
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05051-0008
Mailing Address - Country:US
Mailing Address - Phone:802-866-3000
Mailing Address - Fax:802-222-5674
Practice Address - Street 1:4628 MAIN ST S
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:VT
Practice Address - Zip Code:05051-9712
Practice Address - Country:US
Practice Address - Phone:802-866-3000
Practice Address - Fax:802-222-5674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)