Provider Demographics
NPI:1538840087
Name:CATHOLIC SOCIAL SERVICES/PASSPORT
Entity type:Organization
Organization Name:CATHOLIC SOCIAL SERVICES/PASSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY ASSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDORA
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:937-575-7132
Mailing Address - Street 1:12635 KIRKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-8101
Mailing Address - Country:US
Mailing Address - Phone:937-710-1765
Mailing Address - Fax:
Practice Address - Street 1:1366 CONSTITUTION AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-2216
Practice Address - Country:US
Practice Address - Phone:937-507-4212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty