Provider Demographics
NPI:1467991752
Name:ST. JOSEPH ORPHANAGE
Entity Type:Organization
Organization Name:ST. JOSEPH ORPHANAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY IMPROVEMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-231-5010
Mailing Address - Street 1:5400 EDALBERT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-7604
Mailing Address - Country:US
Mailing Address - Phone:513-741-3100
Mailing Address - Fax:
Practice Address - Street 1:5400 EDALBERT DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-7604
Practice Address - Country:US
Practice Address - Phone:513-741-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01-0219251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2531960Medicaid
OH2531960Medicaid