# KINGSWAY HEALTH SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720792658
- **Authorized official:** KINGSLEY EBORU (ADMINISTRATOR)
- **Authorized official phone:** (602) 405-5067

## Contact information

- **Practice address:** 13231 W CREOSOTE DR, PEORIA, AZ 85383-7843
- **Practice address phone:** (602) 405-5067
- **Mailing address:** 13231 W CREOSOTE DR, PEORIA, AZ 85383-7843
- **Mailing address phone:** (602) 405-5067

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/05/2023
- **Last updated:** 02/17/2023