Healthcare Provider Details

I. General information

NPI: 1750913703
Provider Name (Legal Business Name): KEY ADVANTAGE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3049 JOHN HAWKINS PKWY STE 116
HOOVER AL
35244-1084
US

IV. Provider business mailing address

3049 JOHN HAWKINS PKWY STE 116
HOOVER AL
35244-1084
US

V. Phone/Fax

Practice location:
  • Phone: 205-386-4118
  • Fax: 205-943-9059
Mailing address:
  • Phone: 205-386-4118
  • Fax: 205-943-9059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DESHONDRA MARIAH WILLIAMS
Title or Position: ADMINISTRATOR
Credential:
Phone: 205-386-4118