Provider Demographics
NPI:1255822391
Name:THE LUND FAMILY CENTER
Entity type:Organization
Organization Name:THE LUND FAMILY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGEMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, LADC
Authorized Official - Phone:802-448-3618
Mailing Address - Street 1:PO BOX 4009
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05406-4009
Mailing Address - Country:US
Mailing Address - Phone:802-864-7467
Mailing Address - Fax:802-864-1619
Practice Address - Street 1:76 GLEN RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4131
Practice Address - Country:US
Practice Address - Phone:802-864-7467
Practice Address - Fax:802-864-1619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness