Healthcare Provider Details

I. General information

NPI: 1669915484
Provider Name (Legal Business Name): RESOURCES OF ENDURING HOPE OUTREACH PROGRAM AND EDUCATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 11/28/2016
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

Practice location:
  • Phone: 937-245-4792
  • Fax:
Mailing address:
  • Phone: 937-245-4792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number150165
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: DR. RONALD LYNN DEBLANC
Title or Position: EXECUTIVE DIRECTOR/THERAPIST
Credential: D.MIN., LICDC-CS, SW
Phone: 937-245-4792