NPIMap

Organization Active NPI

Graceworks Enhanced Living

Doing business as Wyoming Home

  • Intellectual Disabilities Intermediate Care Facility
  • Cincinnati, OH
National Provider Identifier
1194981720
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
GRACEWORKS ENHANCED LIVING
Doing business as
Wyoming Home
Practice address
1227 Springfield Pike
Cincinnati, OH 45215-2123
Phone
(513) 761-3999
Fax
(513) 761-4765
NPI assigned
Aug 4, 2008
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 Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

1227 Springfield Pike
Cincinnati, OH 45215-2123

Mailing address

11370 Springfield Pike
Cincinnati, OH 45246-4202
Phone (513) 612-6500

Other identifiers 1

IdentifierTypeStateIssuer
2900632MedicaidOH

Other names 1

  • Wyoming Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G636

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
GRACEWORKS ENHANCED LIVING WYOMING HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jun 27, 2008
Last certification
Nov 4, 2025
Beds
10
Ownership / control type
Private (non-profit)
Facility address
1227 Springfield Pike
Wyoming, OH 45215

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1194981720",
    "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",
            "telephone_number": "513-612-6500",
            "fax_number": "513-612-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 SPRINGFIELD PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452152123",
            "telephone_number": "513-761-3999",
            "fax_number": "513-761-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEWORKS ENHANCED LIVING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRACEWORKS ENHANCED LIVING",
        "enumeration_date": "2008-08-04",
        "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": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2900632",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyoming Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wyoming Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.