Healthcare Provider Details
I. General information
NPI: 1104962208
Provider Name (Legal Business Name): KEA,INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2007
Last Update Date: 09/02/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2911 CAMERON ST
MONROE LA
71201-3713
US
IV. Provider business mailing address
2911 CAMERON ST STE A
MONROE LA
71201-3713
US
V. Phone/Fax
- Phone: 318-651-9363
- Fax:
- Phone: 318-699-8606
- Fax: 318-651-9251
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | 1476030 |
| License Number State | LA |
VIII. Authorized Official
Name: MR.
KERRY
JEFFERSON
SCOTT
Title or Position: ADMINISTRATOR
Credential: LAC
Phone: 318-651-9363