# DIOCESAN COUNCIL OF THE SOCIETY OF ST. VINCENT DE PAUL DIOCESE OF PHX

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St. Vincent de Paul Virginia G. Piper Medical & Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952572240
- **Authorized official:** JANICE ERTL RN, MHSA (CLINIC DIRECTOR)
- **Authorized official phone:** (602) 261-6880

## Contact information

- **Practice address:** 420 W WATKINS RD, PHOENIX, AZ 85003-2830
- **Practice address phone:** (602) 261-6825
- **Mailing address:** PO BOX 13600, PHOENIX, AZ 85002-3600
- **Mailing address phone:** (602) 261-6825
- **Mailing address fax:** (602) 261-6816

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | OTC 0669 | AZ | Yes |

## Other

- **Enumeration date:** 03/14/2008
- **Last updated:** 03/14/2008