Provider Demographics
NPI:1952678641
Name:HISPANIC COUNCIL ON SOCIAL POLICY CENTER FOR COMMUNITY DEVELOPMENT
Entity Type:Organization
Organization Name:HISPANIC COUNCIL ON SOCIAL POLICY CENTER FOR COMMUNITY DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:R
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-689-6612
Mailing Address - Street 1:PO BOX 9413
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07509-9413
Mailing Address - Country:US
Mailing Address - Phone:973-689-6612
Mailing Address - Fax:973-841-5156
Practice Address - Street 1:1 MARKET ST
Practice Address - Street 2:SUITE 3
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-1703
Practice Address - Country:US
Practice Address - Phone:973-689-6612
Practice Address - Fax:973-841-5156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251S00000X, 323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility