Provider Demographics
NPI: | 1639267404 |
---|---|
Name: | HOWARDCENTER, INC. |
Entity Type: | Organization |
Organization Name: | HOWARDCENTER, INC. |
Other - Org Name: | HOWARDCENTER FOR HUMAN SERVICES |
Other - Org Type: | Former Legal Business Name |
Authorized Official - Title/Position: | DIRECTOR OF FINANCE& ADMINISTRATION |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SANDY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MCGUIRE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 802-488-6900 |
Mailing Address - Street 1: | 208 FLYNN AVE |
Mailing Address - Street 2: | SUITE 3J |
Mailing Address - City: | BURLINGTON |
Mailing Address - State: | VT |
Mailing Address - Zip Code: | 05401-5429 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 802-488-6900 |
Mailing Address - Fax: | 802-488-6919 |
Practice Address - Street 1: | 300 FLYNN AVE |
Practice Address - Street 2: | |
Practice Address - City: | BURLINGTON |
Practice Address - State: | VT |
Practice Address - Zip Code: | 05401-5301 |
Practice Address - Country: | US |
Practice Address - Phone: | 802-488-6103 |
Practice Address - Fax: | 802-488-6919 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-10-10 |
Last Update Date: | 2021-05-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VT | 251C00000X, 251S00000X, 261QD1600X, 310400000X | |
261QM0801X, 261QM0855X, 261QR0405X, 320800000X, 322D00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
No | 251S00000X | Agencies | Community/Behavioral Health | |
No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
VT | 1001098 | Medicaid | |
VT | 6060009 | Medicaid | |
VT | 1007275 | Medicaid | |
VT | 00006190 | Medicaid | |
VT | 047W159 | Medicaid | |
VT | 1006429 | Medicaid | |
VT | 1006429 | Medicaid |