Provider Demographics
NPI:1891864310
Name:JUDSON CARE CENTER, INC.
Entity Type:Organization
Organization Name:JUDSON CARE CENTER, INC.
Other - Org Name:JUDSON HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PIEPENBRINK
Authorized Official - Suffix:
Authorized Official - Credentials:MHA, LNHA
Authorized Official - Phone:513-662-5880
Mailing Address - Street 1:2373 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-7927
Mailing Address - Country:US
Mailing Address - Phone:513-662-5880
Mailing Address - Fax:513-389-7846
Practice Address - Street 1:2373 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-7927
Practice Address - Country:US
Practice Address - Phone:513-662-5880
Practice Address - Fax:513-389-7846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2285647Medicaid
367608Medicare ID - Type Unspecified