Provider Demographics
NPI:1285847327
Name:PASSAIC COUNTY DEPARTMENT OF SENIOR SERVICES
Entity type:Organization
Organization Name:PASSAIC COUNTY DEPARTMENT OF SENIOR SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-569-4060
Mailing Address - Street 1:930 RIVERVIEW DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512
Mailing Address - Country:US
Mailing Address - Phone:973-569-4060
Mailing Address - Fax:973-256-5190
Practice Address - Street 1:930 RIVERVIEW DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512
Practice Address - Country:US
Practice Address - Phone:973-569-4060
Practice Address - Fax:973-256-5190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8989605Medicaid