Provider Demographics
NPI:1831595644
Name:ST. JOSEPH INFANT AND MATERNITY HOME
Entity type:Organization
Organization Name:ST. JOSEPH INFANT AND MATERNITY HOME
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RENCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-563-2520
Mailing Address - Street 1:10722 WYSCARVER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-3061
Mailing Address - Country:US
Mailing Address - Phone:513-563-2520
Mailing Address - Fax:513-563-1958
Practice Address - Street 1:10722 WYSCARVER RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-3061
Practice Address - Country:US
Practice Address - Phone:513-563-2520
Practice Address - Fax:513-563-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3102734251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services