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General NPI Number Information
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NPI Number | 1376094110
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Entity Type | Organization
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Legal Business Name | CARTER HOUSE
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Dates
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Enumeration Date | 10/17/2016
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Last Update Date | 10/17/2016
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Provider Practice Location Address
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Address Line | 994 LINCOLN AVE
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City | GIRARD
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State | OH
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Zip | 44420-1946
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Country | US
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Telephone | 330-234-8555
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Fax | 234-421-5747
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Provider Business Mailing Address
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Address Line | 994 LINCOLN
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City | GIRARD
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State | OH
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Zip | 44420
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Country | US
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Telephone | 330-234-8555
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Fax | 234-421-5747
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MISS NORMAN L CARTER I
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Credential | CDCA
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Telephone | 330-559-1312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 160365
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License Number State | OH
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