Healthcare Provider Details

I. General information

NPI: 1588219901
Provider Name (Legal Business Name): CATHOLIC CHARITIES DIOCESE OF TRENTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 WHITEHORSE HAMILTON SQUARE RD STE 5&6
HAMILTON NJ
08690-3541
US

IV. Provider business mailing address

383 W STATE ST
TRENTON NJ
08618-5705
US

V. Phone/Fax

Practice location:
  • Phone: 609-394-5157
  • Fax:
Mailing address:
  • Phone: 609-394-3202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DEB ELKO
Title or Position: ASSOCIATE EXECUTIVE DIRECTOR OF FIN
Credential:
Phone: 609-394-5181