Organization
JCORBITTLLC
Active
Other names
Family First
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETTY JEAN WALLACE LICDC (SUPERVISER)
(937) 422-4349
Entity
Organization
Contact information
Practice address
3688 WALES DRIVE, DAYTON, OH 45406-2439
(937) 607-9170
Mailing address
3688 WALES DR, DAYTON, OH 45405-1845
(937) 607-9170
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
2241108
OH
Other
Enumeration date
07/07/2015
Last updated
07/27/2015
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