Healthcare Provider Details

I. General information

NPI: 1154937688
Provider Name (Legal Business Name): ACCLAIM SENIOR ACTIVITIES CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 09/21/2020
Certification Date: 09/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3878 INDIAN RIPPLE RD
BEAVERCREEK OH
45440-3448
US

IV. Provider business mailing address

3878 INDIAN RIPPLE RD
BEAVERCREEK OH
45440-3448
US

V. Phone/Fax

Practice location:
  • Phone: 937-912-9061
  • Fax:
Mailing address:
  • Phone: 937-912-9061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: PAULLECIA BROWN-SCOTT
Title or Position: EXECUTIVE DIRECTOR
Credential: COTA/L
Phone: 937-912-9061