Organization · NPI-2

A Fair Life Home

Clinic/Center, Mental Health (Including Community Mental Health Center) · Dayton, OH

NPI number1407559545
StatusActive
Last updated in NPPESMar 27, 2023

Details

NPI
1407559545
Entity type
Organization (NPI-2)
Legal business name
A Fair Life Home
Organization subpart
No
Enumeration date
Mar 27, 2023
Certification date
Mar 26, 2023
Last updated
Mar 27, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

1700 Needmore Rd
Dayton, OH 45414-3804

Phone 937-300-3887

Mailing address

1700 Needmore Rd
Dayton, OH 45414-3804

Phone 937-300-3887

Authorized official

Kayla Fair-Fleming
Rn
9373042907

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