Provider Demographics
NPI:1144404591
Name:CEDAR RAPIDS KEYS TO LIVING
Entity Type:Organization
Organization Name:CEDAR RAPIDS KEYS TO LIVING
Other - Org Name:KEYS TO LIVING COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:319-377-2161
Mailing Address - Street 1:5250 N PARK PL NE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-6221
Mailing Address - Country:US
Mailing Address - Phone:319-377-2161
Mailing Address - Fax:319-377-2094
Practice Address - Street 1:5250 N PARK PL NE
Practice Address - Street 2:SUITE 209
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-6221
Practice Address - Country:US
Practice Address - Phone:319-377-2161
Practice Address - Fax:319-377-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health