Healthcare Provider Details

I. General information

NPI: 1134376932
Provider Name (Legal Business Name): KEY CARE HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2008
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 NORTHWOOD RD
LEXINGTON SC
29072-2130
US

IV. Provider business mailing address

PO BOX 84246
LEXINGTON SC
29073-0005
US

V. Phone/Fax

Practice location:
  • Phone: 803-449-0046
  • Fax:
Mailing address:
  • Phone: 803-490-0046
  • Fax: 803-490-0036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REBECCA GUERRA
Title or Position: ADMINISTRATOR
Credential:
Phone: 803-485-1284