Provider Demographics
NPI:1811372436
Name:CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTER
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTER
Other - Org Name:CATHOLIC CHARITIES OF WAYNE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:DOHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-331-4867
Mailing Address - Street 1:94 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-1830
Mailing Address - Country:US
Mailing Address - Phone:315-789-1377
Mailing Address - Fax:315-789-4339
Practice Address - Street 1:1141 E UNION ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-9201
Practice Address - Country:US
Practice Address - Phone:315-331-4867
Practice Address - Fax:315-331-4918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty