# ST. MARY'S HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750402202
- **Authorized official:** MR. ROBERT BODNAR (DIRECTOR OF PATIENT ACCOUNTS)
- **Authorized official phone:** (973) 365-3012

## Contact information

- **Practice address:** 33 MINERAL SPRING AVE, PASSAIC, NJ 07055-2512
- **Practice address phone:** (973) 470-3181
- **Mailing address:** 350 BOULEVARD, PASSAIC, NJ 07055-2840
- **Mailing address phone:** (973) 365-3012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 30407R05Y107 | NJ | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 08/22/2020