Provider Demographics
NPI:1831302041
Name:CATHOLIC FAMILY AND COMMUNITY SERVICES INC
Entity Type:Organization
Organization Name:CATHOLIC FAMILY AND COMMUNITY SERVICES INC
Other - Org Name:MOUNT SAINT JOSEPH'S CHILDREN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:MPA,MNM
Authorized Official - Phone:973-279-7100
Mailing Address - Street 1:24 DEGRASSE ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07505-2001
Mailing Address - Country:US
Mailing Address - Phone:973-279-7100
Mailing Address - Fax:973-523-1150
Practice Address - Street 1:124 SHEPHERD LN
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2130
Practice Address - Country:US
Practice Address - Phone:973-595-5720
Practice Address - Fax:973-595-1930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8373205Medicaid