Healthcare Provider Details

I. General information

NPI: 1215692801
Provider Name (Legal Business Name): NITASHA KEYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20001 EUCLID AVE
EUCLID OH
44117-1480
US

IV. Provider business mailing address

5577 AIRPORT HWY STE 200
TOLEDO OH
43615-7364
US

V. Phone/Fax

Practice location:
  • Phone: 216-465-9942
  • Fax:
Mailing address:
  • Phone: 419-720-0442
  • Fax: 419-754-2085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: