Provider Demographics
NPI:1841572914
Name:DIOCESAN CATHOLIC CHILDREN'S HOME
Entity Type:Organization
Organization Name:DIOCESAN CATHOLIC CHILDREN'S HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CHILDREN'S SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:859-331-2040
Mailing Address - Street 1:75 ORPHANAGE RD
Mailing Address - Street 2:P. O. BOX # 17007
Mailing Address - City:FT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3006
Mailing Address - Country:US
Mailing Address - Phone:859-331-2040
Mailing Address - Fax:859-344-5022
Practice Address - Street 1:75 ORPHANAGE RD
Practice Address - Street 2:
Practice Address - City:FT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-3006
Practice Address - Country:US
Practice Address - Phone:859-331-2040
Practice Address - Fax:859-344-5022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty