Provider Demographics
NPI:1821484247
Name:JUDSON CARE CENTER
Entity Type:Organization
Organization Name:JUDSON CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:COCH
Authorized Official - Suffix:
Authorized Official - Credentials:CFY
Authorized Official - Phone:724-466-9145
Mailing Address - Street 1:3225 OAKLEY STATION BLVD
Mailing Address - Street 2:APT 120
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1276
Mailing Address - Country:US
Mailing Address - Phone:724-466-9145
Mailing Address - Fax:
Practice Address - Street 1:3225 OAKLEY STATION BLVD
Practice Address - Street 2:APT 120
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1276
Practice Address - Country:US
Practice Address - Phone:724-466-9145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility