Organization
GRACE ADULT PROGRAMMING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SMITH (CEO)
(937) 360-4412
Entity
Organization
Contact information
Practice address
3705 MIDDLE URBANA RD, SPRINGFIELD, OH 45502-9200
(937) 360-4412
Mailing address
4469 HAWK RD, MECHANICSBURG, OH 43044-9653
(937) 360-4412
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0379898
—
OH
Enumeration date
11/13/2020
Last updated
11/13/2020
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