Provider Demographics
NPI:1053470047
Name:HUDSON CO BOARD OF CHOSEN FREEHOLD ADMIN
Entity Type:Organization
Organization Name:HUDSON CO BOARD OF CHOSEN FREEHOLD ADMIN
Other - Org Name:HC MEADOWVIEW PSYCHIATRIC HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:OLAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-369-5252
Mailing Address - Street 1:595 COUNTY AVE BLDG 10
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2605
Mailing Address - Country:US
Mailing Address - Phone:201-369-5252
Mailing Address - Fax:201-369-5261
Practice Address - Street 1:595 COUNTY AVE BLDG 10
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-2605
Practice Address - Country:US
Practice Address - Phone:201-319-5252
Practice Address - Fax:201-369-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ60908283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0372650Medicaid
NJ31-4024Medicare ID - Type Unspecified