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General NPI Number Information
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NPI Number | 1508617721
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Entity Type | Organization
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Legal Business Name | CITY OF REFUGE DBA ONE WAY FARM
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 5990 MICHAEL RD
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City | MIDDLETOWN
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State | OH
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Zip | 45042-9201
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Country | US
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Telephone | 513-829-3276
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Fax |
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Provider Business Mailing Address
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Address Line | 5990 MICHAEL RD
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City | MIDDLETOWN
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State | OH
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Zip | 45042-9201
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Country | US
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Telephone | 513-829-3276
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | CHERYL LEE BRANSTUTTER
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Credential |
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Telephone | 937-244-6827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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