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General NPI Number Information
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NPI Number | 1043561582
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Entity Type | Organization
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Legal Business Name | KEYS TO LIFE HOME HEALTH PARTNERS LLC
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Dates
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Enumeration Date | 09/24/2012
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Last Update Date | 07/28/2013
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Provider Practice Location Address
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Address Line | 3379 CORTEZ DR
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City | DAYTON
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State | OH
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Zip | 45415-2723
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Country | US
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Telephone | 937-409-4430
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Fax | 937-985-5824
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Provider Business Mailing Address
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Address Line | PO BOX 103
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City | DAYTON
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State | OH
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Zip | 45401-0103
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Country | US
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Telephone | 937-409-4430
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Fax | 937-985-5824
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Authorized Official
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Title or Position | OWNER
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Name | MS. PIRA ALEXIS WILLIAMS
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Credential | LPN
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Telephone | 937-409-4430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PN125422-IV
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License Number State | OH
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