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General NPI Number Information
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NPI Number | 1487030003
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Entity Type | Organization
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Legal Business Name | GREAT HEALTH INC.
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 08/05/2015
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Provider Practice Location Address
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Address Line | 922 CREIGHTON AVE
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City | DAYTON
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State | OH
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Zip | 45410-2923
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Country | US
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Telephone | 937-671-2273
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Fax | 937-610-3297
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Provider Business Mailing Address
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Address Line | 922 CREIGHTON AVE
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City | DAYTON
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State | OH
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Zip | 45410-2923
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Country | US
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Telephone | 937-671-2273
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Fax | 937-610-3297
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GRANT TURNER DIXON JR.
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Credential |
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Telephone | 937-671-2273
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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 | 1998481
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License Number State | OH
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