Provider Demographics
NPI:1093461428
Name:KEYS FOR LIFE BEHAVIORAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:KEYS FOR LIFE BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICA DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAFAYETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-316-4242
Mailing Address - Street 1:2240 PALM BEACH LAKES BLVD STE 304B
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3410
Mailing Address - Country:US
Mailing Address - Phone:561-316-4242
Mailing Address - Fax:
Practice Address - Street 1:2240 PALM BEACH LAKES BLVD STE 304B
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3410
Practice Address - Country:US
Practice Address - Phone:561-316-4242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)