Provider Demographics
NPI:1629700497
Name:NORTH EAST KINGDOM COMMUNITY ACTION, INC.
Entity Type:Organization
Organization Name:NORTH EAST KINGDOM COMMUNITY ACTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-424-2797
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-0346
Mailing Address - Country:US
Mailing Address - Phone:803-424-2797
Mailing Address - Fax:
Practice Address - Street 1:115 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-2449
Practice Address - Country:US
Practice Address - Phone:802-748-6040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management