MEDICARE: KEY TO CARE HOME CARE SERVICES, 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	376J00000X	Homemaker
2	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1790500890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEY TO CARE HOME CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	2560 GALAXY LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-1124
Country	:	US
Telephone Number	:	317-840-9714
Fax Number	:

Provider Business Practice Location Address
First Line	:	2560 GALAXY LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-1124
Country	:	US
Telephone Number	:	317-840-9714
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KIERRA MASON
Credential	:
Telephone Number	:	317-840-9714

Provider Enumeration Date	:	11/22/2024
Last Update Date	:	11/22/2024

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