Northeast Kingdom Human Services INC Mh Waiver

NPI #1124152004 in Newport, Vermont

Provider Information

NPI Number: 1124152004
Entity Type: Organization
Organization Name: Northeast Kingdom Human Services INC Mh Waiver
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Mar 15, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 154 DUCHESS ST
City: Newport
State: Vermont
ZIP Code: 05855
Phone: (802) 334-6744

Authorized Official

Name: MR. ERIC GRIMS
Title: CHIEF EXECUTIVE OFFICER
Phone: (802) 334-6744

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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