Basic Information
| Provider Information | |||||||||
| NPI: | 1881731578 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ST. VINCENT DE PAUL SOCIETY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 169 STILLMAN | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159771270 | ||||||||
| FaxNumber: | 4159771271 | ||||||||
| Practice Location | |||||||||
| Address1: | 525 5TH STREET | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155977970 | ||||||||
| FaxNumber: | 4155797946 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 07/30/2008 | ||||||||
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| AuthorizedOfficialLastName: | CODY | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | T. | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4159771270 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.