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General NPI Number Information
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NPI Number | 1366253932
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Entity Type | Organization
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Legal Business Name | KESHIA LEE ESTATE
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 726 EGLESTON AVE SUITE 4
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City | KALAMAZOO
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State | MI
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Zip | 49001
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Country | US
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Telephone | 269-419-3752
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 MILLER RD STE 3612
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City | KALAMAZOO
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State | MI
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Zip | 49001-9998
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Country | US
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Telephone | 269-910-0958
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE
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Name | LEE KESHIA MARIE
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Credential | ESQ
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Telephone | 269-419-3752
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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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