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General NPI Number Information
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NPI Number | 1588379465
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Entity Type | Organization
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Legal Business Name | DEE'S PLACE
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 2030 KIPLING DR
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City | DAYTON
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State | OH
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Zip | 45406-3822
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Country | US
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Telephone | 937-430-0720
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 KIPLING DR
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City | DAYTON
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State | OH
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Zip | 45406-3822
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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 | DIRECTOR
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Name | RICHARD JOHNSON
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Credential |
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Telephone | 937-430-0720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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