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General NPI Number Information
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NPI Number | 1831429026
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES
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Dates
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Enumeration Date | 01/11/2010
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 305 HANSON AVE STE 180
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3134
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Country | US
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Telephone | 540-371-1124
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Fax | 540-371-9038
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Provider Business Mailing Address
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Address Line | 305 HANSON AVE STE 180
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3134
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Country | US
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Telephone | 540-371-1124
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Fax | 540-371-9038
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. STEVE LUTERAN
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Credential | LCSW
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Telephone | 703-841-3835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0701004719
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License Number State | VA
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