Provider Demographics
NPI:1245580307
Name:CHATHOLIC CHARITIES
Entity Type:Organization
Organization Name:CHATHOLIC CHARITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:MARK
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:216-432-0682
Mailing Address - Street 1:3135 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2531
Mailing Address - Country:US
Mailing Address - Phone:216-432-0682
Mailing Address - Fax:
Practice Address - Street 1:3135 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2531
Practice Address - Country:US
Practice Address - Phone:216-432-0682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0009131324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility