Healthcare Provider Details

I. General information

NPI: 1790500890
Provider Name (Legal Business Name): KEY TO CARE HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2024
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 GALAXY LN
INDIANAPOLIS IN
46229-1124
US

IV. Provider business mailing address

2560 GALAXY LN
INDIANAPOLIS IN
46229-1124
US

V. Phone/Fax

Practice location:
  • Phone: 317-840-9714
  • Fax:
Mailing address:
  • Phone: 317-840-9714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: KIERRA MASON
Title or Position: CEO
Credential:
Phone: 317-840-9714