Provider Demographics
NPI:1710102769
Name:SAINT VINCENT'S SERVICES, INC.
Entity Type:Organization
Organization Name:SAINT VINCENT'S SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:LAMORA
Authorized Official - Last Name:DUTRA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-679-8511
Mailing Address - Street 1:2425 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-4508
Mailing Address - Country:US
Mailing Address - Phone:508-679-8511
Mailing Address - Fax:508-679-0953
Practice Address - Street 1:2425 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-4508
Practice Address - Country:US
Practice Address - Phone:508-679-8511
Practice Address - Fax:508-679-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA48X36261QM0855X
MA322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children