Provider Demographics
NPI:1881021772
Name:OUR LADY OF BELLEFONTE HOSPITAL INC.
Entity Type:Organization
Organization Name:OUR LADY OF BELLEFONTE HOSPITAL INC.
Other - Org Name:PEDIATRIC REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:ASIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-215-0203
Mailing Address - Street 1:1100 SAINT CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7055
Mailing Address - Country:US
Mailing Address - Phone:606-833-6713
Mailing Address - Fax:
Practice Address - Street 1:1100 SAINT CHRISTOPHER DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7055
Practice Address - Country:US
Practice Address - Phone:606-833-6713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)