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General NPI Number Information
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NPI Number | 1780997254
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Entity Type | Organization
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Legal Business Name | KEYESE HOME CARE LLC
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 1900 WALTMAN RD
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City | EDGEWOOD
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State | MD
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Zip | 21040-2338
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Country | US
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Telephone | 443-402-0491
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 218
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City | EDGEWOOD
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State | MD
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Zip | 21040-0218
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Country | US
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Telephone | 443-402-0491
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SHARON KEISE
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Credential |
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Telephone | 443-402-0491
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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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