Provider Demographics
NPI:1366113730
Name:CATHOLIC CHARITIES DIOCESE OF METUCHEN
Entity type:Organization
Organization Name:CATHOLIC CHARITIES DIOCESE OF METUCHEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:JORGE
Authorized Official - Last Name:COTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-324-8200
Mailing Address - Street 1:319 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4101
Mailing Address - Country:US
Mailing Address - Phone:732-324-8200
Mailing Address - Fax:
Practice Address - Street 1:1100 BROOKS BLVD
Practice Address - Street 2:
Practice Address - City:MANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08835-1542
Practice Address - Country:US
Practice Address - Phone:732-324-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty