NPIMap

Organization Active NPI

Graceworks Enhanced Living

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Beavercreek, OH
National Provider Identifier
1073100111
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
GRACEWORKS ENHANCED LIVING
Practice address
3372 Cross Creek CT
Beavercreek, OH 45432-2767
Phone
(937) 306-8305
NPI assigned
Dec 23, 2020
Organization subpart
Yes
Parent organization
GRACEWORKS ENHANCED LIVINGAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael W Allen
Title
Vice President, Finance & Facilitie
Phone
(937) 436-6885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

3372 Cross Creek CT
Beavercreek, OH 45432-2767

Mailing address

11370 Springfield Pike
Cincinnati, OH 45246-4202

Other names 1

  • Cross Creek Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Graceworks Enhanced Living46 organizations share this tax ID, including this one
Part of
Graceworks Enhanced Living

Other organizations with this tax ID 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1073100111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11370 SPRINGFIELD PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452464202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3372 CROSS CREEK CT",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322767",
            "telephone_number": "937-306-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEWORKS ENHANCED LIVING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRACEWORKS ENHANCED LIVING",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VICE PRESIDENT, FINANCE & FACILITIE",
        "authorized_official_telephone_number": "937-436-6885",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cross Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.