Organization
AMAZING GRACE TREATMENT CENTER, INC.
Active
Organization
AMAZING GRACE TREATMENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYES'A NELLOMS ADN, QMHS (PROGRAM MANAGER)
(937) 231-8773
Entity
Organization
Contact information
Practice address
17 INDIANA AVE, DAYTON, OH 45410-2307
(937) 640-3400
Mailing address
17 INDIANA AVE, DAYTON, OH 45410-2307
(937) 640-3400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/12/2024
Last updated
03/23/2026
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