MEDICARE: KEY ASSETS KENTUCKY, INC.

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	251S00000X	Community/Behavioral Health Agency	800189	KY

General Provider Information

NPI Number	:	1558747790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEY ASSETS KENTUCKY, INC.

Provider Business Mailing Address
First Line	:	961 BEASLEY ST STE 170
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-4120
Country	:	US
Telephone Number	:	859-226-5025
Fax Number	:

Provider Business Practice Location Address
First Line	:	961 BEASLEY ST STE 170
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-4120
Country	:	US
Telephone Number	:	859-226-5025
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING AGENT
Name	:	MELINDA KINNEY
Credential	:
Telephone Number	:	859-270-9097

Provider Enumeration Date	:	08/10/2015
Last Update Date	:	06/25/2024

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