# GRACEWORKS ENHANCED LIVING

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

## Provider details

- **NPI number:** 1225102932
- **Legal business name:** GRACEWORKS ENHANCED LIVING
- **Authorized official:** MR. MICAHEL W ALLEN (VICE PRESIDENT, FINANCE & FACILITIE)
- **Authorized official phone:** (937) 436-6885

## Contact information

- **Practice address:** 4208 ROMAN DR, DAYTON, OH 45415-2424
- **Practice address phone:** (937) 854-4518
- **Mailing address:** 11370 SPRINGFIELD PIKE, CINCINNATI, OH 45246-4202
- **Mailing address phone:** (513) 612-6500
- **Mailing address fax:** (513) 612-6545

## Taxonomy

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

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 12/23/2020