Provider Demographics
NPI:1740203843
Name:CATHOLIC CHARITIES SOUTHWESTERN OHIO
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES SOUTHWESTERN OHIO
Other - Org Name:CATHOLIC CHARITIES OF SOUTHWESTERN OHIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-241-7745
Mailing Address - Street 1:7162 READING RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-3838
Mailing Address - Country:US
Mailing Address - Phone:513-241-7745
Mailing Address - Fax:513-241-4333
Practice Address - Street 1:7162 READING RD
Practice Address - Street 2:SUITE 600
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-3838
Practice Address - Country:US
Practice Address - Phone:513-241-7745
Practice Address - Fax:513-241-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or Charitable
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01274OtherUCI
OH21700Medicaid
OH0368OtherODMH CERTIFICATION NUMBER
OH2919677Medicaid