Provider Demographics
NPI:1790520013
Name:ST. CHRISTOPHER EPISCOPAL CHURCH
Entity type:Organization
Organization Name:ST. CHRISTOPHER EPISCOPAL CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:GEOFFREY
Authorized Official - Last Name:BUCKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-477-5728
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-1026
Mailing Address - Country:US
Mailing Address - Phone:937-477-5728
Mailing Address - Fax:
Practice Address - Street 1:1501 N BROAD ST
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-5575
Practice Address - Country:US
Practice Address - Phone:937-477-5728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services