GRACEWORKS ENHANCED LIVING
Intermediate Care Facility, Mentally Retarded
Cincinnati, Ohio
Provider NPI: 1205900917
Organization Information:Organization Name: GRACEWORKS ENHANCED LIVING
Practice Location:
11651 WALNUT ST CINCINNATI, OH 45246 US
Tel: 513-671-2654 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
11651 WALNUT ST CINCINNATI, OH 45246 US
Tel: 513-671-2654 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | OH | 3112143 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
2032740 | OH | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin