NPI 1003403155

Graceworks Enhanced Living

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility West Carrollton, OH

Practice location

Address: 204 W Main St, West Carrollton, OH 45449-1424
Phone: (937) 530-8042
Mailing address: 11370 Springfield Pike, Cincinnati, OH 45246-4202

Authorised official

Name: Michael W. Allen
Title: Vice President, Finance & Facilitie
Phone: (937) 436-6885

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1003403155
Entity type: Organization
NPI issued: 23 Dec 2020
Record last updated: 23 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.