# GRACEWORKS ENHANCED LIVING

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grant C
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730356585
- **Authorized official:** MR. MICHAEL W ALLEN (VICE PRESIDENT FINANCE & FACILITIE)
- **Authorized official phone:** (937) 436-6885

## Contact information

- **Practice address:** 3752 GRANT AVE APT C, BEAVERCREEK, OH 45431-1588
- **Practice address phone:** (937) 673-1427
- **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:** 05/12/2008
- **Last updated:** 12/23/2020