Provider Demographics
NPI:1821429960
Name:CATHOLIC CHARITIES OF THE ARCHDIOCESE OF NEWARK
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE ARCHDIOCESE OF NEWARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTERVELT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-596-4100
Mailing Address - Street 1:249 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1423
Mailing Address - Country:US
Mailing Address - Phone:973-639-5031
Mailing Address - Fax:
Practice Address - Street 1:249 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1423
Practice Address - Country:US
Practice Address - Phone:973-639-5031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05890200251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health