Provider Demographics
NPI:1568019909
Name:VINCENT ACADEMY
Entity Type:Organization
Organization Name:VINCENT ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LA PLANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-452-2100
Mailing Address - Street 1:2501 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-2477
Mailing Address - Country:US
Mailing Address - Phone:510-452-2100
Mailing Address - Fax:
Practice Address - Street 1:2501 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-2477
Practice Address - Country:US
Practice Address - Phone:510-452-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)