Organization
GRACEWORKS ENHANCED LIVING
Active
Parent organization
GRACEWORKS ENHANCED LIVING
Other names
Fredericksburg
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRACEWORKS ENHANCED LIVING
Authorized official
MR. MICHAEL W ALLEN (VICE PRESIDENT, FINANCE & FACILITIE)
(937) 436-6885
Entity
Organization
Contact information
Practice address
612 FREDERICKSBURG DR, DAYTON, OH 45415-2649
(937) 331-8141
Mailing address
11370 SPRINGFIELD PIKE, CINCINNATI, OH 45246-4202
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/31/2020
Last updated
12/31/2020
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