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General NPI Number Information
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NPI Number | 1669915484
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Entity Type | Organization
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Legal Business Name | RESOURCES OF ENDURING HOPE OUTREACH PROGRAM AND EDUCATION, INC.
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 11/28/2016
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Provider Practice Location Address
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Address Line | 1443 STEINER AVE
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City | DAYTON
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State | OH
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Zip | 45417-3813
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Country | US
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Telephone | 937-245-4792
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Fax |
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Provider Business Mailing Address
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Address Line | 1443 STEINER AVE
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City | DAYTON
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State | OH
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Zip | 45417-3813
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Country | US
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Telephone | 937-245-4792
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/THERAPIST
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Name | DR. RONALD LYNN DEBLANC
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Credential | D.MIN., LICDC-CS, SW
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Telephone | 937-245-4792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 150165
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | OH
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Taxonomy #3
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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 | OH
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | OH
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