Healthcare Provider Details

I. General information

NPI: 1407069578
Provider Name (Legal Business Name): TOWARD INDEPENDENCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 E MAIN ST
XENIA OH
45385-3201
US

IV. Provider business mailing address

81 E MAIN ST
XENIA OH
45385-3201
US

V. Phone/Fax

Practice location:
  • Phone: 937-376-3996
  • Fax: 937-376-2046
Mailing address:
  • Phone: 937-376-3996
  • Fax: 937-376-2046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number0849229
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number0849229
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number0849229
License Number StateOH

VIII. Authorized Official

Name: MR. ROBERT ARCHER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 937-376-3996