Individual provider · NPI-1

Lisa Davis

Custodial Care Facility, Adult Care Home · Dayton, OH

NPI number1134043359
StatusActive
Last updated in NPPESAug 10, 2026

Details

NPI
1134043359
Entity type
Individual (NPI-1)
Name
Mrs. Lisa Davis
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 10, 2026
Certification date
Aug 9, 2026
Last updated
Aug 10, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
311ZA0620X Custodial Care Facility, Adult Care Home–OHYes

Practice location

2104 Willow Oak Ct
Dayton, OH 45439-0003

Phone 937-397-7273

Mailing address

2104 Willow Oak Ct
Dayton, OH 45439-0003

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