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General NPI Number Information
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NPI Number | 1841348471
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Entity Type | Organization
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Legal Business Name | KEETONI CASE MANAGEMENT, LLC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4001 OFFICE COURT DR, SUITE 407
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City | SANTA FE
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State | NM
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Zip | 87507
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Country | US
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Telephone | 505-438-8288
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Fax | 505-438-0880
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Provider Business Mailing Address
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Address Line | 4001 OFFICE COURT DR, SUITE 407
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City | SANTA FE
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State | NM
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Zip | 87507
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Country | US
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Telephone | 505-438-8288
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Fax | 505-438-0880
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELYN M KEETON
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Credential |
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Telephone | 505-438-8288
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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 | D2343
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License Number State | NM
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