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GOODWILL EASTER SEALS MIAMI VALLEY NPI 1619291838


NPI Information

NPI: 1619291838
Provider Name: GOODWILL EASTER SEALS MIAMI VALLEY

Former Legal Business Name: GOODWILL INDUSTRIES

Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization
Address:
660 S MAIN ST
DAYTON, OH
ZIP 45402
Phone: (937) 461-4800
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GOODWILL EASTER SEALS MIAMI VALLEY is a day training developmentally disabled services in Dayton, OH. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. GOODWILL EASTER SEALS MIAMI VALLEY NPI is 1619291838. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Goodwill Industries.

The provider's business location address is:

660 S MAIN ST
DAYTON, OH
ZIP 45402-708
Phone: (937) 461-4800
Fax: (937) 461-9578

The provider's authorized official is Graig Tuschong .
The authorized official title is Cfo and has the following contact phone number (937) 461-4800.

The enumeration date for this NPI number is 3/17/2010 and was last updated on 3/13/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA0600XClinic/CenterAdult Day CareNo
2251C00000XDay Training, Developmentally Disabled ServicesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12284504MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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