Association of Africans Living in Vermont

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ASSOCIATION OF AFRICANS LIVING IN VERMONT

Practice address

20 Allen St FL 3
Burlington, VT 05401-4344

Phone

(802) 985-3106

NPI assigned

Jul 18, 2018

Last updated

Jul 18, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yacouba Jacob Bogre

Title

Executive Director

Phone

(802) 985-3106

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1407332893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ALLEN ST FL 3",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ALLEN ST FL 3",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014344",
            "telephone_number": "802-985-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATION OF AFRICANS LIVING IN VERMONT",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "BOGRE",
        "authorized_official_first_name": "YACOUBA",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "802-985-3106"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Burlington, VT
• Providers in Burlington, VT by specialty
• Community/Behavioral Health Agency in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.