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General NPI Number Information
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NPI Number | 1023312386
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Entity Type | Organization
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Legal Business Name | KEYSTYLE LIVING, LLC
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Dates
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Enumeration Date | 12/30/2010
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 512 BAYSHORE RD
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City | NOKOMIS
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State | FL
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Zip | 34275-1912
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Country | US
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Telephone | 941-484-1222
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Fax | 941-485-6808
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Provider Business Mailing Address
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Address Line | 512 BAYSHORE RD
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City | NOKOMIS
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State | FL
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Zip | 34275-1912
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Country | US
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Telephone | 941-484-1222
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Fax | 941-485-6808
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. MONICA ELIZABETH DOWHAN
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Credential |
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Telephone | 941-484-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number | AL11852
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number | AL11852
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | AL11852
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | AL11852
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | AL11852
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | AL11852
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | AL11852
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL11852
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License Number State | FL
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