| Organization Name: | VINEYARD HEALTHCARE ASSOC. |
| NPI Number: | 1194949073 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHERYL A CHURCH (OFFICE MANAGER) |
| Mailing Address: | 455 State Rd Ste 13 Vineyard Haven |
| State: | MA US |
| Postal Code: | 025685621 |
| Phone Number: | 5086933900 |
| Fax Number: | 5086930444 |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0401X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | A family medicine physician who specializes in the diagnosis and treatment of addictions. |