Organization
CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD BALCOM (CFO)
(516) 733-7032
Entity
Organization
Contact information
Practice address
30 CARLOUGH RD STE C, BOHEMIA, NY 11716-2919
(631) 589-4144
(631) 589-3281
Mailing address
90 CHERRY LN, HICKSVILLE, NY 11801-6232
(516) 733-7040
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
12049
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12049
OASAS OPERATING CERTIFICATE
NY
Enumeration date
03/31/2017
Last updated
03/31/2017
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