Organization
CATHOLIC CHARITIES OF THE DIOCESE OF ROCKVILLE CENTRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BALCOM (CFO)
(516) 733-7032
Entity
Organization
Contact information
Practice address
333 N MAIN ST, FREEPORT, NY 11520-1231
(516) 623-3322
Mailing address
90 CHERRY LN, HICKSVILLE, NY 11801-6232
(516) 733-7040
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
6814107A
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6814107A
OMH OPERATING CERTIFICATE
NY
Enumeration date
07/22/2006
Last updated
08/19/2013
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