Provider Demographics
NPI:1376094110
Name:CARTER HOUSE
Entity Type:Organization
Organization Name:CARTER HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:I
Authorized Official - Credentials:CDCA
Authorized Official - Phone:330-559-1312
Mailing Address - Street 1:994 LINCOLN
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420
Mailing Address - Country:US
Mailing Address - Phone:330-234-8555
Mailing Address - Fax:234-421-5747
Practice Address - Street 1:994 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-1946
Practice Address - Country:US
Practice Address - Phone:330-234-8555
Practice Address - Fax:234-421-5747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH160365251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management