Provider Demographics
NPI:1144331380
Name:JUDSON CARE CENTER INC.
Entity type:Organization
Organization Name:JUDSON CARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IT VP
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:I
Authorized Official - Last Name:WEISBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-292-5706
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:513-389-7840
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:513-389-7840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH620024314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH152730Medicaid
OH152730Medicaid