Provider Demographics
NPI:1245643857
Name:CLIFTON CARE CENTER, INC.
Entity type:Organization
Organization Name:CLIFTON CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-530-1622
Mailing Address - Street 1:4700 ASHWOOD DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241
Mailing Address - Country:US
Mailing Address - Phone:513-489-7100
Mailing Address - Fax:513-489-7199
Practice Address - Street 1:625 PROBASCO ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2710
Practice Address - Country:US
Practice Address - Phone:513-281-2464
Practice Address - Fax:513-281-2559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1567N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0234428Medicaid
OH365304Medicare Oscar/Certification