MEDICARE: CATHOLIC CHARITIES CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1518907351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC CHARITIES CORPORATION

Provider Business Mailing Address
First Line	:	2270 PROFESSOR AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-4467
Country	:	US
Telephone Number	:	216-871-0288
Fax Number	:	216-781-6270

Provider Business Practice Location Address
First Line	:	2270 PROFESSOR AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-4467
Country	:	US
Telephone Number	:	216-871-0288
Fax Number	:	216-781-6270

Authorized Official
Title or Position	:	PRESIDENT & CHIEF EXECUTIVE OFICCER
Name	:	MR. PATRICK GAREAU
Credential	:
Telephone Number	:	216-334-2901

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	01/17/2013

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Directions to “CATHOLIC CHARITIES CORPORATION ” Practice Location

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