Organization
ST VINCENT PREVENTATIVE FAMILY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT SEABORN (CEO)
(901) 337-3003
Entity
Organization
Contact information
Practice address
1221 W 3RD ST, LOS ANGELES, CA 90017-5181
(901) 337-3003
Mailing address
1221 W 3RD ST, LOS ANGELES, CA 90017-5181
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
251X00000X
Supports Brokerage Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
06/07/2022
Last updated
07/13/2023
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