Provider Demographics
NPI:1366125866
Name:ST VINCENT DE PAUL SOCIAL SERVICES, INC.
Entity type:Organization
Organization Name:ST VINCENT DE PAUL SOCIAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOUSING MISNITIRES
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHRISTOPOHER
Authorized Official - Last Name:GOEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, LCDC III
Authorized Official - Phone:937-681-0943
Mailing Address - Street 1:120 W APPLE ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2617
Mailing Address - Country:US
Mailing Address - Phone:937-222-7349
Mailing Address - Fax:937-461-7837
Practice Address - Street 1:1540 BROWNLEIGH RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3928
Practice Address - Country:US
Practice Address - Phone:937-630-3950
Practice Address - Fax:630-395-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health