Provider Demographics
NPI:1023175692
Name:CHRIST HOSPITAL
Entity type:Organization
Organization Name:CHRIST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTAKE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAVERAS
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:201-795-8375
Mailing Address - Street 1:179 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1103
Mailing Address - Country:US
Mailing Address - Phone:201-795-8375
Mailing Address - Fax:
Practice Address - Street 1:179 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1103
Practice Address - Country:US
Practice Address - Phone:201-795-8375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty