Organization
SOUTH COMMUNITY
Active
Other names
Behavioral Heathcare
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VALENCIA LANIER TERRELL INTERN (STUDENT)
(937) 293-8300
Entity
Organization
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 293-8300
(937) 534-1350
Mailing address
1339 KINGSLEY AVE, DAYTON, OH 45406-4220
(937) 276-2899
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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