Provider Demographics
NPI:1639819279
Name:SENIOR CENTERS OF OHIO INC.
Entity Type:Organization
Organization Name:SENIOR CENTERS OF OHIO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:FULTON
Authorized Official - Last Name:FOUCHE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:216-970-8001
Mailing Address - Street 1:7243 SOMERVILLE DR
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44146-5912
Mailing Address - Country:US
Mailing Address - Phone:216-970-8001
Mailing Address - Fax:
Practice Address - Street 1:21400 SOUTHGATE PARK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-2906
Practice Address - Country:US
Practice Address - Phone:844-735-2834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care