Provider Demographics
NPI:1023108222
Name:NORTHEAST KINGDOM LEARNING SERVICES, INC FIT
Entity type:Organization
Organization Name:NORTHEAST KINGDOM LEARNING SERVICES, INC FIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:TARRYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-334-6532
Mailing Address - Street 1:55 SEYMOUR LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-2199
Mailing Address - Country:US
Mailing Address - Phone:802-334-6532
Mailing Address - Fax:802-334-6555
Practice Address - Street 1:101 MAIN ST
Practice Address - Street 2:
Practice Address - City:LYNDONVILLE
Practice Address - State:VT
Practice Address - Zip Code:05851-9103
Practice Address - Country:US
Practice Address - Phone:802-626-1131
Practice Address - Fax:802-626-1141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare