Organization
ADVANCED THERAPEUTIC SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY FRANK KOLACZKOWSKI MSW LISW LCSW (EXECUTIVE DIRECTOR)
(937) 223-1781
Entity
Organization
Contact information
Practice address
1320 WOODMAN DR, STE 200, DAYTON, OH 45432
(937) 223-1781
(937) 853-0096
Mailing address
1320 WOODMAN DR, STE 200, DAYTON, OH 45432
(937) 223-1781
(937) 853-0096
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2299196
—
OH
Enumeration date
11/09/2005
Last updated
03/24/2008
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