MEDICARE: KEYS TO LOVE, 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1144716408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEYS TO LOVE, LLC

Provider Business Mailing Address
First Line	:	7441 MARVIN D LOVE FWY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3490
Country	:	US
Telephone Number	:	214-875-6842
Fax Number	:

Provider Business Practice Location Address
First Line	:	7441 MARVIN D LOVE FWY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3490
Country	:	US
Telephone Number	:	214-875-6842
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	LASHONDRA BOLLIN
Credential	:
Telephone Number	:	214-875-6842

Provider Enumeration Date	:	07/10/2018
Last Update Date	:	07/10/2018

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Directions to “KEYS TO LOVE, LLC ” Practice Location

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