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General NPI Number Information
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NPI Number | 1164386470
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Entity Type | Organization
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Legal Business Name | KINGSLEYAN HEALTHCARE SERVICES
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 1 ELIZABETH PL STE 100
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City | DAYTON
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State | OH
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Zip | 45417-3445
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Country | US
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Telephone | 937-624-9119
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Fax |
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Provider Business Mailing Address
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Address Line | 1974 STEPPING STONE CT
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City | CENTERVILLE
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State | OH
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Zip | 45458-6500
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Country | US
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Telephone | 937-624-9119
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KINGSLEY OROCK
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Credential | PHARM.D
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Telephone | 937-624-9119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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