Organization
GRACEWORKS ENHANCED LIVING
Active
Other names
Gideon
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
11481 GIDEON LN, CINCINNATI, OH 45249-1601
(513) 247-0358
(513) 247-0765
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
3114426
OH
Other
Enumeration date
02/15/2016
Last updated
12/23/2020
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