MEDICARE: KEYUANTE DOWNEY

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	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1568188415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEYUANTE DOWNEY

Provider Business Mailing Address
First Line	:	12337 JONES RD STE 200-7
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4892
Country	:	US
Telephone Number	:	832-712-7899
Fax Number	:

Provider Business Practice Location Address
First Line	:	12337 JONES RD STE 200-7
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4892
Country	:	US
Telephone Number	:	832-712-7899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	10/13/2022

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Directions to “ KEYUANTE DOWNEY ” Practice Location

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