Provider Demographics
NPI:1457308975
Name:CATHOLIC CHARITIES OF THE DIOCESE OF PALM BEACH, INC.
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOCESE OF PALM BEACH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEVERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-775-9560
Mailing Address - Street 1:9995 N MILITARY TRAIL
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-775-9560
Mailing Address - Fax:561-625-5906
Practice Address - Street 1:9995 N MILITARY TRAIL
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-775-9560
Practice Address - Fax:561-625-5906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-29
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251V00000XAgenciesVoluntary or CharitableGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9192Medicare PIN