Provider Demographics
NPI:1083772628
Name:CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTER
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTER
Other - Org Name:CATHOLIC CHARITIES OF CHEMUNG SCHUYLER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:STEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-734-9784
Mailing Address - Street 1:215 E CHURCH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2743
Mailing Address - Country:US
Mailing Address - Phone:607-734-9784
Mailing Address - Fax:607-734-6588
Practice Address - Street 1:215 E CHURCH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2743
Practice Address - Country:US
Practice Address - Phone:607-734-9784
Practice Address - Fax:607-734-6588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01304723Medicaid