Organization
GRACEWORKS ENHANCED LIVING
Active
Other names
Grant C
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL W ALLEN (VICE PRESIDENT FINANCE & FACILITIE)
(937) 436-6885
Entity
Organization
Contact information
Practice address
3752 GRANT AVE APT C, BEAVERCREEK, OH 45431-1588
(937) 673-1427
Mailing address
11370 SPRINGFIELD PIKE, CINCINNATI, OH 45246-4202
(513) 612-6500
(513) 612-6545
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/12/2008
Last updated
12/23/2020
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