Organization
BOLD COMMUNITY CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COURTNEY WASHINGTON (CHIEF EXECUTIVE OFFICER)
(973) 444-6440
Entity
Organization
Contact information
Practice address
224 CHERRY STREET, ROSELLE, NJ 07203
(973) 444-6440
Mailing address
224 CHERRY ST, ROSELLE, NJ 07203-1913
(973) 444-6440
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
Primary
—
—
Other
Enumeration date
09/19/2017
Last updated
07/21/2022
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