Organization
DAYTON VETERANS AFFAIRS MEDICAL CENTER
Active
Organization
DAYTON VETERANS AFFAIRS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIO MANCINI JR. CRC (VOCATIONAL REHABILITATION SPECIALIS)
(937) 268-6511
Entity
Organization
Contact information
Practice address
3547 FAR HILLS AVE, KETTERING, OH 45429-2501
(937) 293-7484
Mailing address
3547 FAR HILLS AVE, KETTERING, OH 45429-2501
(937) 293-7484
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
S-0016717
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00016730
CERTIFICATION
OH
Enumeration date
10/16/2006
Last updated
08/22/2020
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