Healthcare Provider Details

I. General information

NPI: 1053115071
Provider Name (Legal Business Name): KEY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1394 JACKSON ST STE 201
SAINT PAUL MN
55117-4630
US

IV. Provider business mailing address

1394 JACKSON ST STE 201
SAINT PAUL MN
55117-4630
US

V. Phone/Fax

Practice location:
  • Phone: 651-603-8774
  • Fax: 855-293-1835
Mailing address:
  • Phone: 651-603-8774
  • Fax: 855-293-1835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: THERESA BOWLIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 651-478-7828