Provider Demographics
NPI:1861641755
Name:NORTHEAST KINGDOM COMMUNITY ACTION, INC.
Entity Type:Organization
Organization Name:NORTHEAST KINGDOM COMMUNITY ACTION, INC.
Other - Org Name:NEKCA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRISSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-334-7316
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:802-334-7316
Mailing Address - Fax:802-334-5249
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-5110
Practice Address - Country:US
Practice Address - Phone:802-334-7316
Practice Address - Fax:802-334-5249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare