Provider Demographics
NPI:1407989213
Name:CATHOLIC FAMILY & COMMUNITY SERVICES
Entity Type:Organization
Organization Name:CATHOLIC FAMILY & COMMUNITY SERVICES
Other - Org Name:HOPE HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBERNAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:973-279-7100
Mailing Address - Street 1:24 DEGRASSE STREET
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07505-2001
Mailing Address - Country:US
Mailing Address - Phone:973-279-7100
Mailing Address - Fax:973-523-1150
Practice Address - Street 1:19-21 BELMONT AVE.
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-0851
Practice Address - Country:US
Practice Address - Phone:973-361-5555
Practice Address - Fax:973-361-5920
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC FAMILY & COMMUNITY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-13
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10118-01-04251S00000X
NJ2000442-12251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7603002Medicaid