Provider Demographics
NPI:1952517518
Name:CATHOLIC CHARITIES
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-893-1313
Mailing Address - Street 1:1213 16TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1032
Mailing Address - Country:US
Mailing Address - Phone:727-893-1313
Mailing Address - Fax:727-893-1307
Practice Address - Street 1:1213 16TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1032
Practice Address - Country:US
Practice Address - Phone:727-893-1313
Practice Address - Fax:727-893-1307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID