Provider Demographics
NPI:1093048159
Name:KEYS COUNSELING, INC.
Entity Type:Organization
Organization Name:KEYS COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:SILVIO
Authorized Official - Middle Name:R
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:219-241-0218
Mailing Address - Street 1:PO BOX 1745
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46352-1745
Mailing Address - Country:US
Mailing Address - Phone:219-809-0333
Mailing Address - Fax:219-809-0334
Practice Address - Street 1:126 W 4TH ST
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-3304
Practice Address - Country:US
Practice Address - Phone:219-809-0333
Practice Address - Fax:219-809-0334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100148310Medicaid
1063544450OtherNPI
IN100148310Medicaid
1063544450OtherNPI