Healthcare Provider Details
I. General information
NPI: 1306084322
Provider Name (Legal Business Name): DEAF COMMUNITY RESOURCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2009
Last Update Date: 01/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 STANLEY AVE
DAYTON OH
45404-2022
US
IV. Provider business mailing address
3333 STANLEY AVE
DAYTON OH
45404-2022
US
V. Phone/Fax
- Phone: 937-227-3272
- Fax: 888-827-9731
- Phone: 937-227-3272
- Fax: 888-827-9731
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CARY
HATTON
Title or Position: CHIEF OPERATING OFFICER
Credential: ED.D.
Phone: 937-227-3272