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Organization

ST.VINCENT'S SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY BENENATI (CONTROLLER)
(718) 422-2204
Entity
Organization

Contact information

Practice address
225-05 131 ST AVE, LAURELTON, NY 11413-1606
(718) 978-0650
Mailing address
225-05 131 ST AVE, LAURELTON, NY 11413-1606
(718) 978-0650

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
09/09/2011
Last updated
09/09/2011
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