Provider Demographics
NPI:1063069201
Name:ST. BENEDICT JOSEPH'S SHELTER, INC.
Entity type:Organization
Organization Name:ST. BENEDICT JOSEPH'S SHELTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDIGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-215-0037
Mailing Address - Street 1:1001 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-2007
Mailing Address - Country:US
Mailing Address - Phone:270-541-1003
Mailing Address - Fax:270-215-0037
Practice Address - Street 1:1001 W 7TH ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-2007
Practice Address - Country:US
Practice Address - Phone:270-541-1003
Practice Address - Fax:270-215-0037
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC CHARITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty