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Organization
GRACEWORKS ENHANCED LIVING
Active
Organization
GRACEWORKS ENHANCED LIVING
Active
Parent organization
GRACEWORKS ENHANCED LIVING
Other names
Springdale Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRACEWORKS ENHANCED LIVING
Authorized official
MR. MICHAEL W ALLEN (VICE PRESIDENT, FINANCE & FACILITIE)
(937) 436-6885
Entity
Organization
Contact information
Practice address
11651 WALNUT ST, CINCINNATI, OH 45246-3046
(513) 671-2654
(513) 671-1293
Mailing address
11370 SPRINGFIELD PIKE, CINCINNATI, OH 45246-4202
(513) 612-6500
(513) 612-6545
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
3112143
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2032740
—
OH
Enumeration date
11/17/2006
Last updated
12/23/2020
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