Provider Demographics
NPI:1891822508
Name:PASSAIC COUNTY BOARD OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:PASSAIC COUNTY BOARD OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATIVE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-881-3208
Mailing Address - Street 1:80 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07505-2024
Mailing Address - Country:US
Mailing Address - Phone:973-881-3208
Mailing Address - Fax:973-345-7125
Practice Address - Street 1:80 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07505-2024
Practice Address - Country:US
Practice Address - Phone:973-881-3208
Practice Address - Fax:973-345-7125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNONE251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0059218Medicaid
NJ0059200Medicaid