Healthcare Provider Details
I. General information
NPI: 1093994071
Provider Name (Legal Business Name): CATHOLIC FAMILY & COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/26/2007
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
163 ROSA PARKS BLVD
PATERSON NJ
07501
US
IV. Provider business mailing address
163 ROSA PARKS BLVD
PATERSON NJ
07501
US
V. Phone/Fax
- Phone: 973-345-5853
- Fax: 973-345-1649
- Phone: 973-345-5853
- Fax: 973-345-1649
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSEPH
F
DUFFY
Title or Position: EXECUTIVE DIRECTOR OF CATHOLIC FAMI
Credential: MAT MA MPA MNM
Phone: 973-279-7100