Individual provider · Type 1 NPI
Tresea Lynn Green
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Dayton, OH
Practice location
300 Marlay Rd
Dayton, OH 45405-1855
Fax (937) 528-7882
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1528656964
Tresea Lynn Green's National Provider Identifier is 1528656964, issued on Dec 31, 2020. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Dayton, OH. The record was last updated on Dec 31, 2020.