Provider Demographics
NPI:1093436875
Name:THE COLLABORATIVE FOR CHILDREN AND FAMILIES
Entity Type:Organization
Organization Name:THE COLLABORATIVE FOR CHILDREN AND FAMILIES
Other - Org Name:CCF COMMUNITY BASED SERVICES (CCF CBS)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAITOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:332-228-1267
Mailing Address - Street 1:200 GRAND COVE WAY APT 2E
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-7215
Mailing Address - Country:US
Mailing Address - Phone:917-213-0130
Mailing Address - Fax:
Practice Address - Street 1:590 AVENUE OF THE AMERICAS
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2022
Practice Address - Country:US
Practice Address - Phone:212-444-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04280397Medicaid