Provider Demographics
NPI:1306833785
Name:LITTLE SISTERS OF THE POOR-CINCINNATI
Entity Type:Organization
Organization Name:LITTLE SISTERS OF THE POOR-CINCINNATI
Other - Org Name:ST. PAUL'S ARCHBISHOP LIEBOLD HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-281-8001
Mailing Address - Street 1:476 RIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-2411
Mailing Address - Country:US
Mailing Address - Phone:513-281-8001
Mailing Address - Fax:513-281-0756
Practice Address - Street 1:476 RIDDLE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2411
Practice Address - Country:US
Practice Address - Phone:513-281-8001
Practice Address - Fax:513-281-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH23007313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0358527Medicaid