Healthcare Provider Details

I. General information

NPI: 1720997307
Provider Name (Legal Business Name): KEASCHE INTEGRATED SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WEYMOUTH ST STE D
ROCKLAND MA
02370-1145
US

IV. Provider business mailing address

500 WESTGATE DR # 1182
BROCKTON MA
02301-1855
US

V. Phone/Fax

Practice location:
  • Phone: 800-711-9373
  • Fax: 800-711-9373
Mailing address:
  • Phone: 800-711-9373
  • Fax: 800-711-9373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. ZAKISHA A GODFREY
Title or Position: OWNER, ADVANCED PRACTICE REG. NURSE
Credential: APRN
Phone: 800-711-9373