Organization
GWENDOLYN BRANDY CHENET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN BRANDY CHENET (OWNER)
(937) 580-7921
Entity
Organization
Contact information
Practice address
4271 CATALPA DR, DAYTON, OH 45405-1717
(937) 580-7921
Mailing address
4271 CATALPA DRIVE, DAYTON, OH 45405
(937) 580-7921
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
RQ746261
OH
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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