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General NPI Number Information
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NPI Number | 1366113730
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES DIOCESE OF METUCHEN
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Dates
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Enumeration Date | 09/24/2021
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 1100 BROOKS BLVD
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City | MANVILLE
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State | NJ
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Zip | 08835-1542
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Country | US
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Telephone | 732-324-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 319 MAPLE ST
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City | PERTH AMBOY
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State | NJ
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Zip | 08861-4101
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Country | US
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Telephone | 732-324-8200
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JULIO JORGE COTO
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Credential |
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Telephone | 732-324-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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