Organization
FIDELITY RESIDENTIAL AND COMMUNITY SUPPOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL NDAYISHIMIYE (CHIEF FINACIAL OFFICER)
(937) 641-1323
Entity
Organization
Contact information
Practice address
5426 WOODGATE DR, DAYTON, OH 45424-2744
(937) 641-1323
Mailing address
5426 WOODGATE DR, DAYTON, OH 45424-2744
(937) 641-1323
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/24/2021
Last updated
12/24/2021
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