Provider Demographics
NPI:1376007682
Name:COMMUNITY HOUSING OF DARKE, MIAMI & SHELBY COUNTIES, INC
Entity type:Organization
Organization Name:COMMUNITY HOUSING OF DARKE, MIAMI & SHELBY COUNTIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUSOE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:931-332-0021
Mailing Address - Street 1:1100 WAYNE AVE SUITE 4001
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373
Mailing Address - Country:US
Mailing Address - Phone:937-332-0021
Mailing Address - Fax:937-332-7966
Practice Address - Street 1:1100 WAYNE AVE SUITE 4001
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373
Practice Address - Country:US
Practice Address - Phone:937-332-0021
Practice Address - Fax:937-332-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty