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Organization

THEE AGENCY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TISCHA ELAINE COATES (CHIEF EXECUTIVE OFFICER)
(937) 671-9117
Entity
Organization

Contact information

Practice address
4661 MERRICK DR, DAYTON, OH 45415-3354
(937) 671-9117
Mailing address
4661 MERRICK DR, DAYTON, OH 45415-3354
(937) 671-9117

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
251E00000X
Home Health Agency
372500000X
Chore Provider
3747P1801X
Personal Care Attendant
Primary
376J00000X
Homemaker
376K00000X
Nurse's Aide
385H00000X
Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
11/28/2022
Last updated
06/20/2023
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