Healthcare Provider Details
I. General information
NPI: 1376494591
Provider Name (Legal Business Name): KEY TO LIFE COMMUNITY PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2026
Last Update Date: 02/04/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15793 EL DORADO DRIVE
CORNING CA
96021
US
IV. Provider business mailing address
455 MARKET ST STE 1940 PMB 450227
SAN FRANCISCO CA
94105-2448
US
V. Phone/Fax
- Phone: 530-209-7148
- Fax:
- Phone: 530-209-7148
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
HUGHES
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: SUDCC # 16996
Phone: 530-209-7148