=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821975434
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KEITH COUNTY SENIOR CITIZENS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2025
-----------------------------------------------------
Last Update Date | 08/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 202 W 1ST ST
-----------------------------------------------------
City | OGALLALA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69153-2532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-289-6740
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 202 W 1ST ST
-----------------------------------------------------
City | OGALLALA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69153-2532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-289-6740
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BOOKKEEPER
-----------------------------------------------------
Name | MRS. PATRICIA J JIMENEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 970-218-0904
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174200000X
-----------------------------------------------------
Taxonomy Name | Meals Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------