# ST VINCENT HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ST VINCENT HEALTHCARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316264567
- **Authorized official:** MR. CIPRIANO BAUTISTA ADMINISTRATOR (ADMINISTRATOR/MEMBER)
- **Authorized official phone:** (626) 398-8182

## Contact information

- **Practice address:** 1810 N FAIR OAKS AVE, PASADENA, CA 91103-1619
- **Practice address phone:** (626) 398-8182
- **Practice address fax:** (626) 398-0473
- **Mailing address:** 1810 N FAIR OAKS AVE, PASADENA, CA 91103-1619
- **Mailing address phone:** (626) 398-8182
- **Mailing address fax:** (626) 398-0473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 970000080 | CA | Yes |

## Other

- **Enumeration date:** 04/28/2010
- **Last updated:** 04/23/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT05773J | — | CA |