Provider Demographics
NPI:1578155123
Name:ST. JOSEPH CARE CENTER
Entity Type:Organization
Organization Name:ST. JOSEPH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:STRUTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-875-5562
Mailing Address - Street 1:2308 RENO DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-9083
Mailing Address - Country:US
Mailing Address - Phone:330-875-5562
Mailing Address - Fax:330-875-8947
Practice Address - Street 1:2308 RENO DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-9083
Practice Address - Country:US
Practice Address - Phone:330-875-5562
Practice Address - Fax:330-875-8947
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. JOSEPH CARE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1587ROtherOHIO DEPARTMENT OF HEALTH