Healthcare Provider Details

I. General information

NPI: 1225396021
Provider Name (Legal Business Name): CATHOLIC CHARITIES CORPROATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 01/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3135 EUCLID AVE
CLEVELAND OH
44115-2531
US

IV. Provider business mailing address

7911 DETROIT AVE
CLEVELAND OH
44102-2815
US

V. Phone/Fax

Practice location:
  • Phone: 216-391-2030
  • Fax:
Mailing address:
  • Phone: 216-391-2030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK GAREAU
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 216-334-2901