Provider Demographics
NPI:1528055126
Name:CATHERINES CARE CENTER INC
Entity type:Organization
Organization Name:CATHERINES CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLGER
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:740-282-3605
Mailing Address - Street 1:575 LOVERS LN
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-3311
Mailing Address - Country:US
Mailing Address - Phone:740-282-3605
Mailing Address - Fax:740-282-2003
Practice Address - Street 1:717 N 6TH AVE
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1832
Practice Address - Country:US
Practice Address - Phone:740-282-3605
Practice Address - Fax:740-282-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4849314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0039514Medicaid
OH0039514Medicaid