Provider Demographics
NPI:1962251033
Name:WELLNESSRIDE OF DAYTON
Entity type:Organization
Organization Name:WELLNESSRIDE OF DAYTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SLUSSER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:937-750-8236
Mailing Address - Street 1:1628 E DOROTHY LN
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3810
Mailing Address - Country:US
Mailing Address - Phone:937-750-8236
Mailing Address - Fax:
Practice Address - Street 1:1628 E DOROTHY LN
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3810
Practice Address - Country:US
Practice Address - Phone:937-750-8236
Practice Address - Fax:937-600-6071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty