GRACEWORKS ENHANCED LIVING (NPI# 1972930659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972930659 |
| Entity Type | Organization |
| Organization Name | GRACEWORKS ENHANCED LIVING |
| Other Organization Name | KITTY HAWK |
| Practice Address |
1939 Kitty Hawk Dr Xenia OH 45385-5372 |
| Mailing Address |
11370 Springfield Pike Cincinnati OH 45246-4202 |
| Practice Telephone | 5139373762 |
| Practice Fax Number | 5136126545 |
| Mailing Telephone | 5136126500 |
| Mailing Fax Number | 5136126545 |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2015-10-31 |
| Authorized Official Name | MR. MICHAEL W ALLEN (VICE PRESIDENT, FINANCE & FACILITIE) |
| Authorized Official Telephone | 9374366885 |
| Is Organization Subpart | Y |
| Parent Organization Name | GRACEWORKS ENHANCED LIVING |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Kitty Hawk | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801255294 | Graceworks Enhanced Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5584 Hugh Dr, Centerville, OH 45459-1617 | 2016-02-15 |
| 1265891642 | Graceworks Enhanced Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 297 Concept Ct, Dayton, OH 45458-2267 | 2016-02-15 |
| 1942669320 | Graceworks Enhanced Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11481 Gideon Ln, Cincinnati, OH 45249-1601 | 2016-02-15 |
| 1477912855 | Graceworks Enhanced Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7741 Glenover Dr, Cincinnati, OH 45236-2145 | 2016-02-15 |
| 1346609732 | Graceworks Enhanced Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1300 Willowdale Ave, Dayton, OH 45429-5148 | 2016-02-15 |
| 1912366303 | Graceworks Enhanced Living | Day Training, Developmentally Disabled Services | 224 N Saint Clair St, Dayton, OH 45402-1230 | 2016-02-15 |
| 1528495637 | Graceworks Enhanced Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4519 Williamsport Dr, Beavercreek, OH 45430-1842 | 2013-10-03 |
| 1053748731 | Graceworks Enhanced Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3690 Shakertown Rd, Beavercreek, OH 45430-1425 | 2013-09-26 |
| 1821422916 | Graceworks Enhanced Living | Intermediate Care Facility, Mentally Retarded | 1045 Kemper Meadow Drive, Forest Park, OH 45240 | 2013-08-26 |
| 1194981720 | Graceworks Enhanced Living | Intermediate Care Facility, Mentally Retarded | 1227 Springfield Pike, Cincinnati, OH 45215-2123 | 2008-08-04 |
| Street Address |
1939 KITTY HAWK DR |
| City | XENIA |
| State | OH |
| Zip Code | 45385-5372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689219008 | Ashley Marie Mosher | Registered Nurse | 1728 Dayton Xenia Road, Xenia, OH 45385 | 2019-11-08 |
| 1255892824 | Hart Behavior Group LLC | Behavioral Analyst | 1690 Kingsway Dr, Xenia, OH 45385 | 2019-03-27 |
| 1053814996 | Briana Creamer | Community/Behavioral Health | 673 Sutton Dr, Xenia, OH 45385 | 2018-03-16 |
| 1174031769 | Maggie Ann Weyandt | Social Worker | 380 Bellbrook Ave., Xenia, OH 45385 | 2018-01-17 |
| 1588116362 | Te Carr | Specialist/Technologist | 1200 Us 42 E, Xenia, OH 45385 | 2016-10-27 |
| 1649678400 | Crystal Misner | Occupational Therapy Assistant | 1694 Pawnee Drive, Xenia, OH 45385 | 2014-12-10 |
| 1750627345 | Claudette May Ross | Registered Nurse | 2301 Dundee Drive, Dayton, OH 45385 | 2012-12-31 |
| 1578868386 | Traditions At Xenia | Assisted Living Facility | 695 Wycliffe Dr, Xenia, OH 45385 | 2011-01-26 |
| 1851624720 | Robert T Morrison Md LLC | Internal Medicine | 215 S. Allison Ave., Xenia, OH 45385 | 2009-09-10 |
| 1790945186 | Tracey D Hacker | Licensed Practical Nurse | 1896 Pueblo Dr, Xenia, OH 45385 | 2008-06-10 |
| Find all providers in zip 45385 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407069578 | Toward Independence Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 81 E Main St, Xenia, OH 45385-3201 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053801 | Vip of Ohio, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2446 Audubon Rd, Akron, OH 44320-1010 | 2020-11-03 |
| 1871190280 | Gateways To Better Living Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6000 Mahoning Ave Ste 234, Youngstown, OH 44515-2225 | 2020-10-08 |
| 1235746264 | Cheryl L Nelson | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 21891 Ringgold Southern Rd, Circleville, OH 43113-9263 | 2020-09-24 |
| 1164039244 | Amberdawn E Kenworthy-byers | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3746 Hickory Ln, Greenville, OH 45331-3014 | 2020-09-23 |
| 1467067124 | Forever Care LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5240 Northtowne Blvd Apt C, Columbus, OH 43229-4661 | 2020-09-10 |
| 1174177737 | Alive Now Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6717 Amsel Ave Ne, Canton, OH 44721-2606 | 2019-07-31 |
| 1154846095 | Anitra L Richardson | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3321 Hackberry St, Cincinnati, OH 45207-1701 | 2017-08-11 |
| 1811447519 | Royal Queens Care Agency | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6625 Retton Rd, Reynoldsburg, OH 43068-2849 | 2016-10-06 |
| 1962958512 | Individual | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1111 Gonder Av Se, Canton, OH 44707 | 2016-09-01 |
| 1700238391 | Rose-mary, The Johanna Grasselli Rehabilitation and Education Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4383 Ammon Rd, Cleveland, OH 44143-2803 | 2016-07-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.