Provider Demographics
NPI:1457616195
Name:UMADAOP
Entity Type:Organization
Organization Name:UMADAOP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:STYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-276-2876
Mailing Address - Street 1:4 WEST PAVILLION
Mailing Address - Street 2:STE 400
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-5417
Mailing Address - Country:US
Mailing Address - Phone:937-276-2176
Mailing Address - Fax:
Practice Address - Street 1:1 ELIZABETH PL
Practice Address - Street 2:4 WEST PAVILLION SUITE 400
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3445
Practice Address - Country:US
Practice Address - Phone:937-276-2176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1043324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility