Healthcare Provider Details

I. General information

NPI: 1992249908
Provider Name (Legal Business Name): THE CENTER FOR AFFORDABLE HOUSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2016
Last Update Date: 12/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E MAIN ST C
TROTWOOD OH
45426-2947
US

IV. Provider business mailing address

501 E MAIN ST C
TROTWOOD OH
45426-2947
US

V. Phone/Fax

Practice location:
  • Phone: 866-748-1003
  • Fax:
Mailing address:
  • Phone: 866-748-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. LEILAND WOODS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 404-782-2988