Healthcare Provider Details

I. General information

NPI: 1891182275
Provider Name (Legal Business Name): DAYTON INDEPENDENT SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2015
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CLAY ST
DAYTON KY
41074-1257
US

IV. Provider business mailing address

200 CLAY STREET
DAYTON KY
41074
US

V. Phone/Fax

Practice location:
  • Phone: 859-491-6565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number210002860
License Number StateKY

VIII. Authorized Official

Name: JAY BREWER
Title or Position: SUPERINTENDENT
Credential:
Phone: 859-491-6565