Provider Demographics
NPI:1275598419
Name:HITCHCOCK CENTER FOR WOMEN, INC
Entity Type:Organization
Organization Name:HITCHCOCK CENTER FOR WOMEN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAZIE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,OCPSII,LISW
Authorized Official - Phone:216-421-0662
Mailing Address - Street 1:1227 ANSEL RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-3323
Mailing Address - Country:US
Mailing Address - Phone:216-421-0662
Mailing Address - Fax:216-421-0911
Practice Address - Street 1:1227 ANSEL RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-3323
Practice Address - Country:US
Practice Address - Phone:216-421-0662
Practice Address - Fax:216-421-0911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH001100Medicare UPIN