Graceworks Enahnced Living

NPI #1922695071 in Englewood, Ohio

Provider Information

NPI Number: 1922695071
Entity Type: Organization
Organization Name: Graceworks Enahnced 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: 4018 WOODRIDGE DR
City: Englewood
State: Ohio
ZIP Code: 45322-2555
Phone: (937) 998-8002

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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