Provider Demographics
NPI:1891821823
Name:CATHOLIC CHARITIES OF THE DIOCESE OF OGDENSBURG INC.
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOCESE OF OGDENSBURG INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIOCESAN DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:315-393-2255
Mailing Address - Street 1:PO BOX 896
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-0896
Mailing Address - Country:US
Mailing Address - Phone:518-483-1460
Mailing Address - Fax:518-483-8240
Practice Address - Street 1:42 FORT COVINGTON ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1035
Practice Address - Country:US
Practice Address - Phone:518-483-1460
Practice Address - Fax:518-483-8240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02494195Medicaid