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Organization
689 SOUTH 16TH STREET CORP
Active
Organization
689 SOUTH 16TH STREET CORP
Active
Other names
Emergency Housing Services
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA MAC EVOY (TRUSTEE)
(973) 271-5802
Entity
Organization
Contact information
Practice address
555 PASSAIC AVENUE, WEST CALDWELL, NJ 07006
(973) 808-9300
Mailing address
555 PASSAIC AVENUE, WEST CALDWELL, NJ 07006
(973) 808-9300
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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