Provider Demographics
NPI:1548373921
Name:CATHOLIC CHARITIES NEIGHBORHOOD SERVICES, INC.
Entity type:Organization
Organization Name:CATHOLIC CHARITIES NEIGHBORHOOD SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLINETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-722-6130
Mailing Address - Street 1:191 JORALEMON ST
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4306
Mailing Address - Country:US
Mailing Address - Phone:718-722-6000
Mailing Address - Fax:
Practice Address - Street 1:191 JORALEMON ST
Practice Address - Street 2:14TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4306
Practice Address - Country:US
Practice Address - Phone:718-722-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6487019A251S00000X
NY6487102A261QM0801X
NY6487101A261QM0801X
NY6487103A261QM0801X
NY6487100A261QM0801X
NY6487150A261QM0801X
NY6487302A251S00000X
NY6487301A251S00000X
NY6487300A251S00000X
NY6487102D261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00244624Medicaid
NYW02311Medicare ID - Type UnspecifiedFLATLANDS MH
NY95429Medicare PIN