Provider Demographics
NPI:1508324062
Name:KEON HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:KEON HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCE-BATAILLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN-BSN
Authorized Official - Phone:862-755-7683
Mailing Address - Street 1:B16 WOODSIDE GDNS
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-1002
Mailing Address - Country:US
Mailing Address - Phone:862-755-7683
Mailing Address - Fax:908-259-5029
Practice Address - Street 1:2165 MORRIS AVE STE 3
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5913
Practice Address - Country:US
Practice Address - Phone:862-755-7683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health