Organization
ST. MARY'S HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT BODNAR (DIRECTOR OF PATIENT ACCOUNTS)
(973) 365-3012
Entity
Organization
Contact information
Practice address
33 MINERAL SPRING AVE, PASSAIC, NJ 07055-2512
(973) 470-3181
Mailing address
350 BOULEVARD, PASSAIC, NJ 07055-2840
(973) 365-3012
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
30407R05Y107
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8368902
—
NJ
Enumeration date
04/03/2007
Last updated
08/22/2020
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