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NPI Code Detail

MEDICARE: KEYES 2 LIFE HOME CARE LLC

MEDICARE: KEYES 2 LIFE HOME CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD1600XDevelopmental Disabilities Clinic/Center
23747P1801XPersonal Care Attendant
3253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1063252823
Entity Type Code : Organization
Provider Name (Legal Business Name) : KEYES 2 LIFE HOME CARE LLC
Provider Business Mailing Address
First Line : 3901 W 86TH ST STE 360
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1799
Country : US
Telephone Number : 317-491-7095
Fax Number :
Provider Business Practice Location Address
First Line : 3901 W 86TH ST STE 360
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1799
Country : US
Telephone Number : 317-491-7095
Fax Number :
Authorized Official
Title or Position : CEO
Name : DEMITRIA KEYES
Credential :
Telephone Number : 317-693-4193
Provider Enumeration Date : 05/29/2024
Last Update Date : 05/29/2024

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Directions to “KEYES 2 LIFE HOME CARE LLC ” Practice Location

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