Organization
CHRISTIAN HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN A STAGG (EXECUTIVE VICE PRESIDENT/CFO)
(201) 848-5200
Entity
Organization
Contact information
Practice address
301 SICOMAC AVE, WYCKOFF, NJ 07481-2159
(201) 848-5200
(201) 848-5493
Mailing address
301 SICOMAC AVE, WYCKOFF, NJ 07481-2159
(201) 848-5200
(201) 848-5493
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
060204
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4463510
—
NJ
Enumeration date
10/04/2006
Last updated
08/22/2020
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