MEDICARE: THEKEY OF COLUMBIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1376256891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THEKEY OF COLUMBIA LLC

Provider Business Mailing Address
First Line	:	7777 FAY AVE STE 210
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-4325
Country	:	US
Telephone Number	:	858-287-3077
Fax Number	:

Provider Business Practice Location Address
First Line	:	4408 FOREST DR STE 203
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-3135
Country	:	US
Telephone Number	:	803-723-2181
Fax Number	:

Authorized Official
Title or Position	:	COMPLIANCE ASSOCIATE
Name	:	SEAN CYGAN
Credential	:
Telephone Number	:	858-287-3077

Provider Enumeration Date	:	12/29/2022
Last Update Date	:	12/29/2022

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Directions to “THEKEY OF COLUMBIA LLC ” Practice Location

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