Graceworks Enhanced Living

NPI #1003403155 in West Carrollton, Ohio

Provider Information

NPI Number: 1003403155
Entity Type: Organization
Organization Name: Graceworks Enhanced Living
Subpart: Yes (part of a larger organization)
Parent Organization: GRACEWORKS ENHANCED LIVING
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Dec 23, 2020
Last Updated: Dec 23, 2020

Practice Location

Address: 204 W MAIN ST
City: West Carrollton
State: Ohio
ZIP Code: 45449-1424
Phone: (937) 530-8042

Authorized Official

Name: MR. MICHAEL W. ALLEN
Title: VICE PRESIDENT, FINANCE & FACILITIE
Phone: (937) 436-6885

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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