Organization
GRACEWORKS LUTHERAN SERVICES
Active
Other names
Bethany Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT A REICHARD CPA (VICE PRESIDENT, FINANCE)
(937) 436-6865
Entity
Organization
Contact information
Practice address
6451 FAR HILLS AVE, DAYTON, OH 45459-2725
(937) 433-2110
Mailing address
6451 FAR HILLS AVE, DAYTON, OH 45459-2725
(937) 433-2110
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0632N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0684255
—
OH
Enumeration date
09/29/2006
Last updated
03/25/2024
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