Healthcare Provider Details
I. General information
NPI: 1114286465
Provider Name (Legal Business Name): RESOURCES OF ENDURING HOPE OUTREACH PROGRAMS AND EDUCATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2012
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1443 STEINER AVE
DAYTON OH
45417-3813
US
IV. Provider business mailing address
1443 STEINER AVE
DAYTON OH
45417-3813
US
V. Phone/Fax
- Phone: 937-754-0528
- Fax:
- Phone: 937-754-0528
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP1600X |
| Taxonomy | Pastoral Counselor |
| License Number | |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | OH |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | OH |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | OH |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | OH |
VIII. Authorized Official
Name: MR.
RONALD
LYNN
DEBLANC
Title or Position: EXECUTIVE DIRECTOR
Credential: MA-PSY, LICDC, SWA
Phone: 937-754-0528