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General NPI Number Information
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NPI Number | 1952946840
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Entity Type | Organization
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Legal Business Name | VINCERE HEALTH INC.
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 11/14/2019
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Provider Practice Location Address
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Address Line | 125 WESTERN AVE
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City | ALLSTON
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State | MA
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Zip | 02134-1008
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Country | US
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Telephone | 248-891-1268
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Fax |
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Provider Business Mailing Address
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Address Line | 125 WESTERN AVE
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City | ALLSTON
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State | MA
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Zip | 02134-1008
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Country | US
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Telephone | 248-891-1268
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JACOB KETEYIAN
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Credential |
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Telephone | 248-891-1268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 364SC1501X
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Taxonomy Name | Community Health/Public Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 364SC2300X
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Taxonomy Name | Chronic Care Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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