Healthcare Provider Details

I. General information

NPI: 1659304129
Provider Name (Legal Business Name): CATHOLIC CHARITIES OF SOUTHWESTERN OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 07/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 FAIRGROVE AVE SUITE B
HAMILTON OH
45011-1930
US

IV. Provider business mailing address

1910 FAIRGROVE AVE SUITE B
HAMILTON OH
45011-1930
US

V. Phone/Fax

Practice location:
  • Phone: 513-863-6129
  • Fax: 513-863-0524
Mailing address:
  • Phone: 513-863-6129
  • Fax: 513-863-0524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. TED BERGH
Title or Position: CEO
Credential:
Phone: 513-241-7745