Provider Demographics
NPI:1518724152
Name:SAINT VINCENT DE PAUL, CONFERENCE OF OUR LADY STAR OF THE SEA
Entity Type:Organization
Organization Name:SAINT VINCENT DE PAUL, CONFERENCE OF OUR LADY STAR OF THE SEA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLHAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-882-4467
Mailing Address - Street 1:3449 WHEATON WAY
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3598
Mailing Address - Country:US
Mailing Address - Phone:360-377-2929
Mailing Address - Fax:
Practice Address - Street 1:1134 N WYCOFF AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-2810
Practice Address - Country:US
Practice Address - Phone:360-265-1549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management