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
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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