# NORTHEAST KINGDOM HUMAN SERVICES INC MH CHILDREN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043343700
- **Authorized official:** MR. ERIC GRIMS (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (802) 334-6744

## Contact information

- **Practice address:** 154 DUCHESS ST, NEWPORT, VT 05855
- **Practice address phone:** (802) 334-6744
- **Practice address fax:** (802) 334-7340
- **Mailing address:** PO BOX 724, NEWPORT, VT 05855-0724
- **Mailing address phone:** (802) 334-6744
- **Mailing address fax:** (802) 334-7340

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1009784 | — | VT |