Provider Demographics
NPI:1932286325
Name:PARENT CHILD CENTER, INC.
Entity Type:Organization
Organization Name:PARENT CHILD CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-388-3171
Mailing Address - Street 1:PO BOX 646
Mailing Address - Street 2:126 MONROE STREET
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-0646
Mailing Address - Country:US
Mailing Address - Phone:802-388-3171
Mailing Address - Fax:802-388-1590
Practice Address - Street 1:126 MONROE ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1345
Practice Address - Country:US
Practice Address - Phone:802-388-3171
Practice Address - Fax:802-388-1590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1004767Medicaid