Provider Demographics
NPI:1013077031
Name:ST. VINCENT HOME CARE SERVICES INC.
Entity Type:Organization
Organization Name:ST. VINCENT HOME CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNAN
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:919-344-4150
Mailing Address - Street 1:1302 E. ASH STREET
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-5106
Mailing Address - Country:US
Mailing Address - Phone:919-731-4850
Mailing Address - Fax:919-731-4855
Practice Address - Street 1:1302 E. ASH STREET
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-5106
Practice Address - Country:US
Practice Address - Phone:919-731-4850
Practice Address - Fax:919-731-4855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
NCHC3584376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty