Provider Demographics
NPI:1316196603
Name:CATHOLIC CHARITIES COMMUNITY SERVICES OF ORANGE COUNTY
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES COMMUNITY SERVICES OF ORANGE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:845-294-5124
Mailing Address - Street 1:224 MAIN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-2157
Mailing Address - Country:US
Mailing Address - Phone:845-294-5124
Mailing Address - Fax:845-294-1369
Practice Address - Street 1:280 BROADWAY
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5408
Practice Address - Country:US
Practice Address - Phone:845-562-8255
Practice Address - Fax:845-562-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090111580261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02739311Medicaid