Provider Demographics
NPI:1104822923
Name:KEEPSAFE CENTER, INC.
Entity Type:Organization
Organization Name:KEEPSAFE CENTER, INC.
Other - Org Name:KEEPSAFE ADULT DAY CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HERMONYONE
Authorized Official - Middle Name:W
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:904-768-6456
Mailing Address - Street 1:5626 SOUTEL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32219-3772
Mailing Address - Country:US
Mailing Address - Phone:904-768-6456
Mailing Address - Fax:904-765-0264
Practice Address - Street 1:5626 SOUTEL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32219-3772
Practice Address - Country:US
Practice Address - Phone:904-768-6456
Practice Address - Fax:904-765-0264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLN11795305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service