Provider Demographics
NPI:1376014845
Name:UNKS PLACE INC
Entity Type:Organization
Organization Name:UNKS PLACE INC
Other - Org Name:HEART TO HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CORNELIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-979-1699
Mailing Address - Street 1:120 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1604
Mailing Address - Country:US
Mailing Address - Phone:938-979-1699
Mailing Address - Fax:
Practice Address - Street 1:120 W 2ND ST STE 425
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1623
Practice Address - Country:US
Practice Address - Phone:938-979-1699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNKS PLACE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-10
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)