Provider Demographics
NPI:1629438692
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:RESIDENT COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-794-8080
Mailing Address - Street 1:9 STARR AVE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-1411
Mailing Address - Country:US
Mailing Address - Phone:845-794-0716
Mailing Address - Fax:
Practice Address - Street 1:17 HAMITON AVE
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-1411
Practice Address - Country:US
Practice Address - Phone:845-794-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility