Provider Demographics
NPI:1558768051
Name:KEY REHABILITATION, INC
Entity Type:Organization
Organization Name:KEY REHABILITATION, INC
Other - Org Name:GEROPSYCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:S
Authorized Official - Last Name:IRWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-362-8704
Mailing Address - Street 1:1335 NW BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-4428
Mailing Address - Country:US
Mailing Address - Phone:888-362-8704
Mailing Address - Fax:888-355-1811
Practice Address - Street 1:430 BARTLES RD
Practice Address - Street 2:
Practice Address - City:DEWEY
Practice Address - State:OK
Practice Address - Zip Code:74029-0520
Practice Address - Country:US
Practice Address - Phone:888-362-8704
Practice Address - Fax:888-355-1811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEY REHABILITATION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty