Provider Demographics
NPI:1790771335
Name:ST VINCENT'S HOME
Entity Type:Organization
Organization Name:ST VINCENT'S HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP FINANCE/CFO
Authorized Official - Prefix:
Authorized Official - First Name:K
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CRONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-828-2024
Mailing Address - Street 1:319 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2116
Mailing Address - Country:US
Mailing Address - Phone:716-366-2066
Mailing Address - Fax:
Practice Address - Street 1:319 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2116
Practice Address - Country:US
Practice Address - Phone:716-366-2066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060E010310400000X, 311Z00000X, 311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Not Answered311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home