Active NPI
Tri County Passaic Teen Center
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Passaic, NJ
National Provider Identifier
1972715142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Legal business name
- TRI COUNTY PASSAIC TEEN CENTER
- Practice address
- 228 Hope Avenue
Passaic, NJ 07055 - Phone
- (973) 473-5755
- Fax
- (973) 470-8999
- NPI assigned
- May 3, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Rasheed I Giles, B.A., MSW
- Title
- Dirctor
- Phone
- (973) 473-5755
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | NJ | Primary |
Addresses
Primary practice location
228 Hope Avenue
Passaic, NJ 07055
Mailing address
228 Hope Avenue
Passaic, NJ 07055
Phone (973) 473-5755
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8373507 | Medicaid | NJ |
Other names 1
- Tri-County Youth Services
National Provider Directory
National Provider Directory- Tax ID family
- Project Youth Haven
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Paterson, NJ
- NPI 1073641908
Locations
228 Hope Ave
Passaic, NJ 07055
Phone (973) 473-5755
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1215648000000",
"number": "1972715142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 HOPE AVENUE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "07055",
"telephone_number": "973-473-5755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "228 HOPE AVENUE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "07055",
"telephone_number": "973-473-5755",
"fax_number": "973-470-8999"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRI COUNTY PASSAIC TEEN CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-03",
"last_updated": "2008-07-10",
"status": "A",
"authorized_official_last_name": "GILES",
"authorized_official_first_name": "RASHEED",
"authorized_official_middle_name": "I",
"authorized_official_title_or_position": "DIRCTOR",
"authorized_official_telephone_number": "973-473-5755",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "B.A., MSW"
},
"taxonomies": [
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": "NJ",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8373507",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Tri-County Youth Services",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Passaic, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.