Healthcare Provider Details

I. General information

NPI: 1639660665
Provider Name (Legal Business Name): UNITED REHABILITATION SERVICES OF GREATER DAYTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2018
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 OLD TROY PIKE
DAYTON OH
45424-5740
US

IV. Provider business mailing address

4710 OLD TROY PIKE
DAYTON OH
45424-5740
US

V. Phone/Fax

Practice location:
  • Phone: 937-233-1230
  • Fax: 937-236-8930
Mailing address:
  • Phone: 937-233-1230
  • Fax: 937-236-8930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number5700469
License Number StateOH

VIII. Authorized Official

Name: DENNIS GRANT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 937-233-1230