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General NPI Number Information
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NPI Number | 1245092089
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Entity Type | Organization
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Legal Business Name | RESERVE ADULT LIVING & DAY SERVICES, LLC
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 110 E POPLAR ST STE 202
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City | SIDNEY
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State | OH
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Zip | 45365-2987
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Country | US
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Telephone | 937-948-8229
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3522
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City | DAYTON
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State | OH
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Zip | 45401-3522
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | MOHAMED ROBLE
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Credential |
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Telephone | 614-468-3661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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