Provider Demographics
NPI:1508191123
Name:THE CINCINNATI CHRISTIAN COLLEGE
Entity Type:Organization
Organization Name:THE CINCINNATI CHRISTIAN COLLEGE
Other - Org Name:THE CINCINNATI CHRISTIAN ADULT MINISTRIES CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:A.
Authorized Official - Middle Name:H
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-281-2103
Mailing Address - Street 1:3663 READING RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2115
Mailing Address - Country:US
Mailing Address - Phone:513-281-2103
Mailing Address - Fax:513-281-2345
Practice Address - Street 1:3663 READING RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2115
Practice Address - Country:US
Practice Address - Phone:513-281-2103
Practice Address - Fax:513-281-2345
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CINCINNATI CHRISTIAN COLLEGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2812424251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2812424Medicaid