Healthcare Provider Details

I. General information

NPI: 1295436970
Provider Name (Legal Business Name): KEY REHABILITATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 RIVERSIDE AVE NE
MCINTOSH MN
56556-5750
US

IV. Provider business mailing address

1335 NW BROAD ST
MURFREESBORO TN
37129-4428
US

V. Phone/Fax

Practice location:
  • Phone: 615-896-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JANET IRWIN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 615-896-6400