Organization
KINGSWAY HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINGSLEY EBORU (ADMINISTRATOR)
(602) 405-5067
Entity
Organization
Contact information
Practice address
13231 W CREOSOTE DR, PEORIA, AZ 85383-7843
(602) 405-5067
Mailing address
13231 W CREOSOTE DR, PEORIA, AZ 85383-7843
(602) 405-5067
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
02/17/2023
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