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General NPI Number Information
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NPI Number | 1326012360
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Entity Type | Organization
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Legal Business Name | PLACES INCORPORATED
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 07/07/2016
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Provider Practice Location Address
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Address Line | 11 W MONUMENT AVE FL 7 SUITE 910
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City | DAYTON
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State | OH
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Zip | 45402-1274
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Country | US
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Telephone | 937-461-4300
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Fax | 937-461-0443
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Provider Business Mailing Address
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Address Line | 11 W MONUMENT AVE 7TH FLOOR
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City | DAYTON
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State | OH
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Zip | 45402-1274
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Country | US
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Telephone | 937-461-4300
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Fax | 937-461-0443
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROY CRAIG
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Credential | M.A.
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Telephone | 937-461-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 0484
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License Number State | OH
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