MEDICARE: REFLECTIONS GROUP HOME LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility
3	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1811588452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFLECTIONS GROUP HOME LLC

Provider Business Mailing Address
First Line	:	5056 GALILEO AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45426-1548
Country	:	US
Telephone Number	:	937-529-4064
Fax Number	:

Provider Business Practice Location Address
First Line	:	5056 GALILEO AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45426-1548
Country	:	US
Telephone Number	:	937-529-4064
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KRISTIN DRAPER
Credential	:
Telephone Number	:	937-654-8775

Provider Enumeration Date	:	01/27/2021
Last Update Date	:	06/28/2023

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