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General NPI Number Information
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NPI Number | 1811325368
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Entity Type | Organization
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Legal Business Name | KEE TO INDEPENDENT GROWTH INC
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Dates
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Enumeration Date | 10/21/2013
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Last Update Date | 10/21/2013
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Provider Practice Location Address
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Address Line | 40 CHURCH AVE
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City | BALLSTON SPA
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State | NY
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Zip | 12020-1903
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Country | US
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Telephone | 518-309-3557
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Fax | 518-309-3558
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Provider Business Mailing Address
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Address Line | PO BOX 243
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City | BALLSTON SPA
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State | NY
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Zip | 12020
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Country | US
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Telephone | 518-309-3557
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Fax | 518-309-3558
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Authorized Official
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Title or Position | PRESIDENT, E.D.
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Name | MRS. KAREN LE'QUE
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Credential | BS, LPN
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Telephone | 518-309-3557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State | NY
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Taxonomy #4
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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 | NY
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