Healthcare Provider Details

I. General information

NPI: 1093461428
Provider Name (Legal Business Name): KEYS FOR LIFE BEHAVIORAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 PALM BEACH LAKES BLVD STE 304B
WEST PALM BEACH FL
33409-3410
US

IV. Provider business mailing address

2240 PALM BEACH LAKES BLVD STE 304B
WEST PALM BEACH FL
33409-3410
US

V. Phone/Fax

Practice location:
  • Phone: 561-316-4242
  • Fax:
Mailing address:
  • Phone: 561-316-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LAFAYETTE E JENKINS
Title or Position: CLINICA DIRECTOR
Credential: LMHC
Phone: 561-316-4242