Healthcare Provider Details

I. General information

NPI: 1710907597
Provider Name (Legal Business Name): INTEGRATED YOUTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 RESEARCH PARK DRIVE
DAYTON OH
45432
US

IV. Provider business mailing address

1321 RESEARCH PARK DRIVE
DAYTON OH
45432
US

V. Phone/Fax

Practice location:
  • Phone: 937-427-3837
  • Fax: 937-427-4516
Mailing address:
  • Phone: 937-427-3837
  • Fax: 937-427-4516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number493
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number11001
License Number StateOH

VIII. Authorized Official

Name: MR. DAVID D NUSCHER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 937-427-3837