Provider Demographics
NPI:1871875468
Name:ST.VINCENT'S SERVICES
Entity type:Organization
Organization Name:ST.VINCENT'S SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENENATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-422-2204
Mailing Address - Street 1:225-05 131 ST AVE
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1606
Mailing Address - Country:US
Mailing Address - Phone:718-978-0650
Mailing Address - Fax:
Practice Address - Street 1:225-05 131 ST AVE
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-1606
Practice Address - Country:US
Practice Address - Phone:718-978-0650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities