Provider Demographics
NPI:1659328771
Name:CATHOLIC CHARITIES CORPORATION
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES CORPORATION
Other - Org Name:CATHOLIC CHARITIES SERVICES OF CUYAHOGA COUNTY MIDTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GAREAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-334-2901
Mailing Address - Street 1:3135 EUCLID AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2531
Mailing Address - Country:US
Mailing Address - Phone:216-391-2030
Mailing Address - Fax:216-391-8946
Practice Address - Street 1:3135 EUCLID AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2531
Practice Address - Country:US
Practice Address - Phone:216-391-2030
Practice Address - Fax:216-391-8946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1121Medicare UPIN