Provider Demographics
NPI:1336295740
Name:ST. VINCENT'S SPECIAL NEEDS CENTER INC
Entity Type:Organization
Organization Name:ST. VINCENT'S SPECIAL NEEDS CENTER INC
Other - Org Name:ST. VINCENT'S SPECIAL NEEDS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUXBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-375-6400
Mailing Address - Street 1:95 MERRITT BLVD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-5435
Mailing Address - Country:US
Mailing Address - Phone:203-380-1190
Mailing Address - Fax:
Practice Address - Street 1:95 MERRITT BLVD
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-5435
Practice Address - Country:US
Practice Address - Phone:203-380-1190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000069231H00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty