Maple Leaf Clinic Pc

LBN: Maple Leaf Clinic Pc
Maple Leaf Clinic Pc is an health care organization with primary practice located at 167 N Main St , Wallingford VT 05773-9800. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Maple Leaf Clinic Pc can be contacted via phone (802) 446-3577, or through Mooney, Dean J via phone (802) 446-3577.

Contact Information

Primary practice address
167 N Main St Wallingford VT 05773-9800
Phone: (802) 446-3577
Fax: (802) 446-3801
Website:
Map and Directions
Authorized official contact:
Name: Mooney, Dean J
Phone: (802) 446-3577

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 620 Vermont

Profile Details

NPI number 1851715635
LBN Legal business name Maple Leaf Clinic Pc
DBA Doing business as
Authorized official Mooney, Dean J
Entity Organization
Organization subpart 1 No
Enumeration date Feb 13th, 2014
Last updated Feb 5th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851715635 NPPES
Vermont MEDICAID 1022361

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