OrganizationActive
St. Mary'S Hospital
NPI 1750402202 · Emotionally Disturbed Childrens' Residential Treatment Facility · Passaic, NJ
Provider details
- NPI number
- 1750402202
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Robert Bodnar, Director of Patient Accounts(973) 365-3012
- License
- 30407R05Y107 (NJ)
Specialties & taxonomies
- Emotionally Disturbed Childrens' Residential Treatment FacilityPrimary322D00000XLicense 30407R05Y107 (NJ)
Residential Treatment Facilities
Practice location
33 Mineral Spring Ave
Passaic, NJ 07055-2512
Phone: (973) 470-3181
Approximate (ZIP-level) locationGet directions
Mailing address
350 Boulevard
Passaic, NJ 07055-2840
Registry dates
- Enumerated
- 2007-04-03
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.