OrganizationActive
Amazing Grace Treatment Center, Inc.
NPI 1043057482 · Mental Illness Community Based Residential Treatment Facility · Dayton, OH
Provider details
- NPI number
- 1043057482
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Tyes'A Nelloms, Program Manager(937) 231-8773
Specialties & taxonomies
Residential Treatment Facilities
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
17 Indiana Ave
Dayton, OH 45410-2307
Phone: (937) 640-3400
Street-level locationGet directions
Mailing address
17 Indiana Ave
Dayton, OH 45410-2307
Registry dates
- Enumerated
- 2024-07-12
- Last updated
- 2026-03-23
- Certified
- 2026-03-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.