Healthcare Provider Details

I. General information

NPI: 1528733755
Provider Name (Legal Business Name): A PLACE OF HOPE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W 1ST ST
DAYTON OH
45402-3007
US

IV. Provider business mailing address

405 W 1ST ST
DAYTON OH
45402-3007
US

V. Phone/Fax

Practice location:
  • Phone: 937-266-5072
  • Fax:
Mailing address:
  • Phone: 937-266-5072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. SHERI ALDRIDGE
Title or Position: PROGRAM SPECIALIST
Credential:
Phone: 937-222-5680