# GRACEWORKS ENHANCED LIVING

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GRACEWORKS ENHANCED LIVING
- **Other names:** West Main
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003403155
- **Legal business name:** GRACEWORKS ENHANCED LIVING
- **Authorized official:** MR. MICHAEL W. ALLEN (VICE PRESIDENT, FINANCE & FACILITIE)
- **Authorized official phone:** (937) 436-6885

## Contact information

- **Practice address:** 204 W MAIN ST, WEST CARROLLTON, OH 45449-1424
- **Practice address phone:** (937) 530-8042
- **Mailing address:** 11370 SPRINGFIELD PIKE, CINCINNATI, OH 45246-4202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 12/23/2020
- **Last updated:** 12/23/2020