ST. MARY'S HOSPITAL (NPI# 1750402202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750402202 |
| Entity Type | Organization |
| Organization Name | ST. MARY'S HOSPITAL |
| Practice Address |
33 Mineral Spring Ave Passaic NJ 07055-2512 |
| Mailing Address |
350 Boulevard Passaic NJ 07055-2840 |
| Practice Telephone | 9734703181 |
| Mailing Telephone | 9733653012 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ROBERT BODNAR (DIRECTOR OF PATIENT ACCOUNTS) |
| Authorized Official Telephone | 9733653012 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 30407R05Y107 | NJ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 8368902 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992931232 | St. Mary's Hospital | Early Intervention Provider Agency | 9226 Avenue J, Brooklyn, Brooklyn, NY 11236-3935 | 2009-06-01 |
| 1932333994 | St. Mary's Hospital | Physical Therapist | 619 4th St, Kamiah, ID 83636 | 2009-05-06 |
| 1427261007 | St. Mary's Hospital | General Acute Care Hospital | 365 Harding Ave, Apt. 2, Clifton, NJ 07011-3626 | 2007-05-08 |
| 1578684023 | St. Mary's Hospital | Community Based Residential Treatment Facility, Mental Illness | 530 Main Ave, Passaic, NJ 07055-5700 | 2007-04-03 |
| 1366480394 | St. Mary's Hospital | Nurse Practitioner | 501 Oak, Nezperce, ID 83543 | 2006-06-03 |
| 1568400562 | St. Mary's Hospital | Nurse Practitioner | 518 Oak, Kamiah, ID 83536 | 2006-06-02 |
| 1770521817 | St. Mary's Hospital | Nurse Practitioner | 320 N Division, Craigmont, ID 83523 | 2006-06-02 |
| 1285630624 | St. Mary's Hospital | Clinic/Center | 205 Huron, Irvington, IL 62848 | 2005-06-21 |
| 1790789451 | St. Mary's Hospital | Clinic/Center | 825 New York Dr, Ste 2, Vandalia, IL 62471-1044 | 2005-06-10 |
| 1356725618 | St. Mary's Hospital | Long Term Care Hospital | 56 Franklin St, Waterbury, CT 06706-1253 | 2015-07-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL FOR CHILDREN, INC. | 2901 216th St, Bayside, NY 11360-2810 |
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL MEDICAL CENTER | 700 S Park St, Madison, WI 53715-1849 |
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL OF SUPERIOR | 3500 Tower Ave, Superior, WI 54880-5335 |
| Colorado Business Entities | St. Mary's Hospital & Medical Center Medical Staff | 2635 N 7th St, Grand Junction, CO 81501 |
| Washington State Corporations | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. | 500 Eldorado Blvd Ste 4300, Attn Chief Legal Officer, Broomfield, CO 80021 |
| Colorado Business Entities | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. | 2635 N. 7th Street, Grand Junction, CO 81501 |
| Colorado Business Entities | ST. MARY'S HOSPITAL FOUNDATION | 2635 N 7th Street, Grand Junction, CO 81501 |
| System for Award Management (SAM) Entities | ST. MARY'S HOSPITAL FOUNDATION | 2635 N 7th St, Grand Junction, CO 81501-8209 |
| System for Award Management (SAM) Entities | ST. MARY'S HOSPITAL LACOR | Juba Road, Gulu, , UGA |
| Massachusetts Corporations | ST. MARY'S HOSPITAL, INC. | 901 45th St., W. Palm Beach, FL 33416 |
| Street Address |
33 MINERAL SPRING AVE |
| City | PASSAIC |
| State | NJ |
| Zip Code | 07055-2512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821417346 | Prime Healthcare Services - St. Mary's Passaic, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 33 Mineral Spring Ave, Passaic, NJ 07055-2512 | 2014-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598300410 | Nilsy Munoz | Counselor | Revelation University Wellness Unit, 307 Monroe St #4, Passaic, NJ 07055 | 2019-11-14 |
| 1093206880 | Capitol Chiropractic and Rehabilitation | Clinic/Center | 15 Howe Ave., 2nd Floor, Passaic, NJ 07055 | 2018-05-29 |
| 1336665827 | 110 Van Houten LLC | Pharmacy | 110 Van Houten Ave, Passaic, NJ 07055 | 2017-08-17 |
| 1528584380 | Lpcnj, LLC | Community/Behavioral Health | 129 Prospect Street, 2nd Floor, Passaic, NJ 07055 | 2017-08-14 |
| 1255851572 | Chana Risa Twersky | Specialist | 164 Ascension St, Passaic, NJ 07055 | 2017-06-27 |
| 1144750241 | Chana Gittel Lemberger | Behavioral Analyst | 277 Pennington Ave, Passaic, NJ 07055 | 2017-06-13 |
| 1205377025 | Glendolin Grant | Massage Therapist | 105 Van Buren St, Passaic, NJ 07055 | 2017-03-13 |
| 1760924310 | Hadassah Selengut | Speech-Language Pathologist | 254 Pennington Ave, Passaic, NJ 07055 | 2016-11-14 |
| 1992180376 | Massiel Parra | Dentist | 625 Main Avenue, Passaic, NJ 07055 | 2015-07-27 |
| 1306240270 | Passaic Pediatrics II Pa | Specialist | 93 Market Street, Passaic, NJ 07055 | 2014-10-21 |
| Find all providers in zip 07055 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972715142 | Tri County Passaic Teen Center | Residential Treatment Facility, Emotionally Disturbed Children | 228 Hope Avenue, Passaic, NJ 07055 | 2007-05-03 |
| 1821417346 | Prime Healthcare Services - St. Mary's Passaic, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 33 Mineral Spring Ave, Passaic, NJ 07055-2512 | 2014-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427519727 | Willowglen Academy - New Jersey. Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 357 Route 94, Newton, NJ 07860-5136 | 2019-03-28 |
| 1649731290 | Willowglen Academy - New Jersey. Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 22 Route 519, Newton, NJ 07860-6230 | 2019-03-27 |
| 1639656705 | Devereux Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 124 Wertsville Rd, Hillsborough, NJ 08844-3908 | 2018-07-23 |
| 1164938049 | Saving Grace Ministries Inc | Residential Treatment Facility, Emotionally Disturbed Children | 436 Spruce St, Camden, NJ 08103-2032 | 2017-12-14 |
| 1790235539 | National Mentor Healthcare, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 8 Dugans Grv, Millstone Twp, NJ 08535-8014 | 2016-10-05 |
| 1619421104 | National Mentor Healthcare, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 201 Stillhouse Rd, Millstone Twp, NJ 08510-7967 | 2016-08-12 |
| 1396192886 | Ranch Hope Inc | Residential Treatment Facility, Emotionally Disturbed Children | 45 Sawmill Rd, Alloway, NJ 08001-1004 | 2016-05-16 |
| 1972972164 | National Mentor Healthcare, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 509 Mine Road, Bethlehem Township, NJ 08802 | 2015-09-18 |
| 1548641459 | Allies, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 46 Featherbed Ln, Flemington, NJ 08822-5638 | 2015-06-16 |
| 1760891055 | Therapeutic Alternatives | Residential Treatment Facility, Emotionally Disturbed Children | 20 Hadley Ln, Suite 100, Willingboro, NJ 08046-1701 | 2014-08-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.