Organization
SOUTH COMMUNITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KENISHA GUICE (THERAPIST)
(937) 534-1596
Entity
Organization
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 534-1596
Mailing address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
S1303477
OH
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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