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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1306104690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC CHARITIES CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 72767
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44192-0001
Country	:	US
Telephone Number	:	440-843-5615
Fax Number	:

Provider Business Practice Location Address
First Line	:	602 SOUTH ST
Second Line	:	SUITE D-1
City	:	CHARDON
State	:	OH
Zip	:	44024-1499
Country	:	US
Telephone Number	:	440-843-5615
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CHIEF EXECUTIVE OFFICER
Name	:	MR. JIM MULLEN
Credential	:
Telephone Number	:	216-334-2901

Provider Enumeration Date	:	04/25/2012
Last Update Date	:	11/20/2025

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Directions to “CATHOLIC CHARITIES CORPORATION ” Practice Location

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