Provider Demographics
NPI:1558587808
Name:CATHOLIC CHARITIES, DIOCESE OF TRENTON
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES, DIOCESE OF TRENTON
Other - Org Name:SALEM AND CAMDEN PARTIAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-394-5181
Mailing Address - Street 1:383 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-5705
Mailing Address - Country:US
Mailing Address - Phone:609-394-3202
Mailing Address - Fax:609-278-6139
Practice Address - Street 1:60 LAUREL LN
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-9626
Practice Address - Country:US
Practice Address - Phone:609-394-3202
Practice Address - Fax:609-278-6139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7311206Medicaid