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General NPI Number Information
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NPI Number | 1679991566
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Entity Type | Organization
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Legal Business Name | EXPRESSIONS OF LIFE INC.
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Dates
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Enumeration Date | 03/29/2014
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Last Update Date | 03/29/2014
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Provider Practice Location Address
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Address Line | 166 CROMWELL PL #1
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City | DAYTON
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State | OH
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Zip | 45405-1771
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Country | US
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Telephone | 937-586-3611
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Fax |
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Provider Business Mailing Address
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Address Line | 166 CROMWELL PL #1
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City | DAYTON
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State | OH
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Zip | 45405-1771
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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 | BOARD SECRETARY
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Name | MR. AARON ANTHONY FROST
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Credential |
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Telephone | 614-586-3611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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