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General NPI Number Information
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NPI Number | 1154547883
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Entity Type | Organization
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Legal Business Name | GOODWILL EASTER SEALS MIAMI VALLEY
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 660 S MAIN ST
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City | DAYTON
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State | OH
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Zip | 45402
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Country | US
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Telephone | 937-461-4800
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Fax | 937-461-9578
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Provider Business Mailing Address
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Address Line | 660 S MAIN ST
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City | DAYTON
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State | OH
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Zip | 45402-2708
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Country | US
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Telephone | 937-461-4800
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Fax | 937-461-9578
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Authorized Official
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Title or Position | VICE PRESIDENT, CFO
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Name | MR. GRAIG TUSCHONG
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Credential |
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Telephone | 937-461-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | S.12248
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 01-0550
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | S.12248
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License Number State | OH
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Taxonomy #8
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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