Provider Demographics
NPI:1043561582
Name:KEYS TO LIFE HOME HEALTH PARTNERS LLC
Entity Type:Organization
Organization Name:KEYS TO LIFE HOME HEALTH PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PIRA
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:937-409-4430
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45401-0103
Mailing Address - Country:US
Mailing Address - Phone:937-409-4430
Mailing Address - Fax:937-985-5824
Practice Address - Street 1:3379 CORTEZ DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2723
Practice Address - Country:US
Practice Address - Phone:937-409-4430
Practice Address - Fax:937-985-5824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2013-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN125422-IV251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1518272095Medicaid