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General NPI Number Information
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NPI Number | 1417710385
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Entity Type | Organization
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Legal Business Name | KEY TO LIFE CARE AGENCY
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Dates
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Enumeration Date | 02/02/2024
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 11015 CRAFT ST
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City | DETROIT
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State | MI
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Zip | 48224-2433
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Country | US
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Telephone | 313-466-0486
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Fax |
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Provider Business Mailing Address
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Address Line | 28401 MOUND RD UNIT 266
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City | WARREN
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State | MI
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Zip | 48090-7210
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Country | US
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Telephone | 313-466-0486
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TEASHA GRIFFIN
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Credential |
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Telephone | 313-466-0486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #8
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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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