Provider Demographics
NPI:1609027887
Name:CATHOLIC CHARITIES, INC. ROMAN CATHOLIC DIOCESE
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES, INC. ROMAN CATHOLIC DIOCESE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:STELLRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:608-821-3100
Mailing Address - Street 1:2020 E MILWAUKEE ST
Mailing Address - Street 2:#9
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-2600
Mailing Address - Country:US
Mailing Address - Phone:608-752-4906
Mailing Address - Fax:608-752-9699
Practice Address - Street 1:2020 E MILWAUKEE ST
Practice Address - Street 2:#9
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-2600
Practice Address - Country:US
Practice Address - Phone:608-752-4906
Practice Address - Fax:608-752-9699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7234-123251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health