Provider Demographics
NPI:1386356970
Name:ASCENSION LIVING ST. VINCENT PACE, INC.
Entity type:Organization
Organization Name:ASCENSION LIVING ST. VINCENT PACE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-224-6591
Mailing Address - Street 1:5435 W PIKE PLAZA RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-3010
Mailing Address - Country:US
Mailing Address - Phone:708-224-6591
Mailing Address - Fax:
Practice Address - Street 1:5435 W PIKE PLAZA RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-3010
Practice Address - Country:US
Practice Address - Phone:708-224-6591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization