SYCAMORE GLEN RETIREMENT COMMUNITY
NPI 1881023885
Assisted Living Facility in Miamisburg, OH

Q: What is Kettering Affiliated Health Services's NPI number?

The NPI number for Kettering Affiliated Health Services is 1881023885. It was assigned to this organization in the NPPES registry on November 11, 2013. The provider is doing business as Sycamore Glen Retirement Community.

Q: What is Kettering Affiliated Health Services's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since November 11, 2013CLIA 36D2298637 · Waiver

317 SYCAMORE GLEN DR, MIAMISBURG, OH 45342(937) 866-2984(937) 866-7488 Get Directions Write a Review

NPPES record last updated: August 2, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 2, 2024, Sep 28, 2022 (2 updates tracked since 2022).

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About Sycamore Glen Retirement Community NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SYCAMORE GLEN RETIREMENT COMMUNITY (NPI 1881023885) is a healthcare organization registered as an assisted living facility in Miamisburg, Ohio and active in the NPI registry since November 2013. The organization holds a CLIA Waiver certificate valid through February 5, 2028 and lists Timothy Ko, Kettering Health Cfo, as its authorized official.

NPPES Registry Identity

NPI1881023885

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameKETTERING AFFILIATED HEALTH SERVICES

Location Address317 SYCAMORE GLEN DRMiamisburg, OH 45342-5720

Mailing Address317 Sycamore Glen DrMiamisburg, OH 45342-5720 · (937) 866-2984 · Fax (937) 866-7488

Phone(937) 866-2984

Fax(937) 866-7488

Organization SubpartYes

Authorized OfficialTimothy KoKettering Health Cfo · (937) 558-3223

Enumeration DateNovember 11, 2013

Last NPPES UpdateAugust 2, 20242 updates tracked since enumeration

NPPES CertifiedAugust 2, 2024

✔ NPI 1881023885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in OH · 1876R

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

317 SYCAMORE GLEN DR, Miamisburg, OH 45342

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Other Names 1

Doing Business AsSycamore Glen Retirement Community

Other Identifiers 1

Medicaid2676886OH

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2298637

Kettering Affiliated Health Services Dba Kettering Health Senior Living · Miamisburg, OH

Active · expires Feb 5, 2028

CLIA Number36D2298637

Laboratory TypeAssisted Living Facility

Certificate Effective DateFebruary 6, 2026

Certificate Expiration DateFebruary 5, 2028

Laboratory DirectorJill Lykins

Laboratory Phone(937) 866-2984

Laboratory LocationKettering Affiliated Health Services Dba Kettering Health Senior Living317 Sycamore Glen Dr, Miamisburg, OH 45342

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kettering Affiliated Health Services's NPI number?

The NPI number for Kettering Affiliated Health Services is 1881023885. It was assigned to this organization in the NPPES registry on November 11, 2013. The provider is doing business as Sycamore Glen Retirement Community.

Where is Kettering Affiliated Health Services located?

Kettering Affiliated Health Services is located at 317 Sycamore Glen Dr, Miamisburg, OH 45342. The listed phone number is (937) 866-2984.

What is Kettering Affiliated Health Services's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Kettering Affiliated Health Services hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2298637) is associated with this NPI, valid through February 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kettering Affiliated Health Services was last updated on August 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.