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General NPI Number Information
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NPI Number | 1558173070
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Entity Type | Organization
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Legal Business Name | KEY HAVEN MANAGEMENT GROUP, LLC
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 4051 NW 43RD ST STE 37
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City | GAINESVILLE
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State | FL
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Zip | 32606-4579
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Country | US
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Telephone | 352-225-3727
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Fax | 888-278-0749
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Provider Business Mailing Address
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Address Line | 4051 NW 43RD ST STE 37
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City | GAINESVILLE
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State | FL
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Zip | 32606-4579
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Country | US
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Telephone | 352-225-3727
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Fax | 888-278-0749
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR & ADMINISTRATOR
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Name | CHRISTINA MARIE RAMOS
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Credential |
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Telephone | 352-225-3727
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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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