Amazing Grace Treatment Center Therapeutic Care, LLC.
Case Management in Dayton, OH. Organization (NPI-2).
NPI number1124960653
StatusActive
Last updated in NPPESApr 6, 2026
Details
- NPI
- 1124960653
- Entity type
- Organization (NPI-2)
- Legal business name
- Amazing Grace Treatment Center Therapeutic Care, LLC.
- Organization subpart
- No
- Enumeration date
- Apr 6, 2026
- Certification date
- Mar 31, 2026
- Last updated
- Apr 6, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251B00000X | Case Management | – | – | Yes |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – | |
| 251S00000X | Community/Behavioral Health | – | – |
Practice location
17 Indiana AveDayton, OH 45410-2307
Phone 937-231-8773
Mailing address
330 W 1st St Apt 905Dayton, OH 45402-3055
Phone 937-231-8773
Authorized official
Tyes'A Nelloms
Program Manager
9372318773
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