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Organization

KETTERING AFFILIATED HEALTH SERVICES

Active
Parent organization
KETTERING AFFILIATED HEALTH SERVICES
Other names
Sycamore Glen Retirement Community
Organization subpart
Yes

Provider details

NPI number
Legal business name
KETTERING AFFILIATED HEALTH SERVICES
Authorized official
TIMOTHY KO (KETTERING HEALTH CFO)
(937) 558-3223
Entity
Organization

Contact information

Practice address
317 SYCAMORE GLEN DR, MIAMISBURG, OH 45342-5720
(937) 866-2984
(937) 866-7488
Mailing address
317 SYCAMORE GLEN DR, MIAMISBURG, OH 45342-5720
(937) 866-2984
(937) 866-7488

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1876R
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2676886
OH
Enumeration date
11/11/2013
Last updated
08/02/2024
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  • Eligibility checks
  • EDI platform