Healthcare Provider Details

I. General information

NPI: 1851197032
Provider Name (Legal Business Name): KEY COMFORT KIDS ATL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 LENOX RD NE STE 750
ATLANTA GA
30326-1353
US

IV. Provider business mailing address

4420 PEACHTREE RD NE APT 2304
BROOKHAVEN GA
30319-2758
US

V. Phone/Fax

Practice location:
  • Phone: 470-895-9054
  • Fax: 470-895-9054
Mailing address:
  • Phone: 413-386-0179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM3000X
TaxonomyMedically Fragile Infants and Children Day Care
License Number
License Number State

VIII. Authorized Official

Name: KIANA WILLIAMS
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 413-386-0179