| NPI | 1679160725 |
|---|---|
| Doing Business As | QUEEN CITY |
| Entity Type | Organization |
| Authorized Contact | MICHAEL W ALLEN Vice President, Finance & Facilitie 937-436-6885 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2020-12-23 |