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NPI Code Detail

MEDICARE: A PLACE OF HOPE, LLC

MEDICARE: A PLACE OF HOPE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility
2251B00000XCase Management Agency

General Provider Information

NPI Number : 1528733755
Entity Type Code : Organization
Provider Name (Legal Business Name) : A PLACE OF HOPE, LLC
Provider Business Mailing Address
First Line : 405 W 1ST ST
Second Line :
City : DAYTON
State : OH
Zip : 45402-3007
Country : US
Telephone Number : 937-266-5072
Fax Number :
Provider Business Practice Location Address
First Line : 405 W 1ST ST
Second Line :
City : DAYTON
State : OH
Zip : 45402-3007
Country : US
Telephone Number : 937-266-5072
Fax Number :
Authorized Official
Title or Position : PROGRAM SPECIALIST
Name : MS. SHERI ALDRIDGE
Credential :
Telephone Number : 937-222-5680
Provider Enumeration Date : 08/10/2021
Last Update Date : 06/23/2022

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Directions to “A PLACE OF HOPE, LLC ” Practice Location

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