Provider Demographics
NPI:1700549052
Name:ST ALBERT FAMILY CLINIC AND SERVICES
Entity Type:Organization
Organization Name:ST ALBERT FAMILY CLINIC AND SERVICES
Other - Org Name:ST ALBERT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TUETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-312-5177
Mailing Address - Street 1:27 ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1147
Mailing Address - Country:US
Mailing Address - Phone:302-312-5177
Mailing Address - Fax:
Practice Address - Street 1:27 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1147
Practice Address - Country:US
Practice Address - Phone:302-312-5177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-14
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No163WG0600XNursing Service ProvidersRegistered NurseGerontologyGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty