Provider Demographics
NPI:1508617721
Name:CITY OF REFUGE DBA ONE WAY FARM
Entity Type:Organization
Organization Name:CITY OF REFUGE DBA ONE WAY FARM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BRANSTUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-244-6827
Mailing Address - Street 1:5990 MICHAEL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-9201
Mailing Address - Country:US
Mailing Address - Phone:513-829-3276
Mailing Address - Fax:
Practice Address - Street 1:5990 MICHAEL RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-9201
Practice Address - Country:US
Practice Address - Phone:513-829-3276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging