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General NPI Number Information
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NPI Number | 1124661608
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Entity Type | Organization
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Legal Business Name | KEY TO LIFE HOMECARE INC.
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 2657 E 14TH ST
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City | BROOKLYN
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State | NY
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Zip | 11235-3915
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Country | US
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Telephone | 347-704-0494
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Fax | 347-704-7336
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Provider Business Mailing Address
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Address Line | 2657 E 14TH ST
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City | BROOKLYN
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State | NY
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Zip | 11235-3915
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Country | US
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Telephone | 347-704-0494
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Fax | 347-704-7336
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GVANTSA RAMISHVILI
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Credential |
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Telephone | 347-704-0494
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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 |
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License Number State |
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