Provider Demographics
NPI:1508455452
Name:KEY OF LIFE CARES, LLC
Entity Type:Organization
Organization Name:KEY OF LIFE CARES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEKEITA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:478-973-5055
Mailing Address - Street 1:350 AMANDA DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31216-6388
Mailing Address - Country:US
Mailing Address - Phone:478-973-5055
Mailing Address - Fax:
Practice Address - Street 1:3040 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2521
Practice Address - Country:US
Practice Address - Phone:478-973-5055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health