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General NPI Number Information
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NPI Number | 1104548080
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Entity Type | Organization
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Legal Business Name | THEKEY OF SOUTHERN VIRGINIA LLC
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 4524 WISHART RD STE 200
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-5527
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Country | US
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Telephone | 757-640-0557
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Fax |
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Provider Business Mailing Address
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Address Line | 7777 FAY AVE STE 210
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City | LA JOLLA
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State | CA
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Zip | 92037-4325
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Country | US
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Telephone | 858-287-3077
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE ASSOCIATE
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Name | MR. SEAN CYGAN
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Credential |
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Telephone | 858-287-3077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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