Healthcare Provider Details

I. General information

NPI: 1548194343
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTERS OF GREATER DAYTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 DOVER ST
DAYTON OH
45410-1925
US

IV. Provider business mailing address

PO BOX 932293
CLEVELAND OH
44193-2293
US

V. Phone/Fax

Practice location:
  • Phone: 937-461-6869
  • Fax:
Mailing address:
  • Phone: 937-586-9733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DANA BALLOU
Title or Position: SENIOR BILLING SPECIALIST
Credential:
Phone: 937-586-9733