Provider Demographics
NPI:1568472462
Name:CATHOLIC CHARITIES DIOCESE OF ST PETERSBURG, INC.
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES DIOCESE OF ST PETERSBURG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-893-1314
Mailing Address - Street 1:1213 16TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1032
Mailing Address - Country:US
Mailing Address - Phone:727-893-1314
Mailing Address - Fax:727-893-1307
Practice Address - Street 1:1423 KASS CIR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4312
Practice Address - Country:US
Practice Address - Phone:352-686-9897
Practice Address - Fax:352-676-1475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management