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GRACEWORKS ENHANCED LIVING

Intermediate Care Facility, Mentally Retarded

Cincinnati, Ohio

Provider NPI: 1508930207

Organization Information:
Organization Name:  GRACEWORKS ENHANCED LIVING


Practice Location:
3731 ISABELLA AVE  CINCINNATI, OH 45209 US
Tel: 513-631-1690  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y320600000XResidential Treatment Facilities
Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities
OH3111939

Other Provider Identifiers:

IssuerNumberStateType
0615070OH05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS OH - Page 1



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