Provider Demographics
NPI:1568067601
Name:KEYS 2 INDEPENDENT LIVING, LLC
Entity Type:Organization
Organization Name:KEYS 2 INDEPENDENT LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASJA
Authorized Official - Middle Name:LAJOI
Authorized Official - Last Name:WYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-902-6988
Mailing Address - Street 1:5810 SOUTHWYCK BLVD STE 101A
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1518
Mailing Address - Country:US
Mailing Address - Phone:567-315-8000
Mailing Address - Fax:
Practice Address - Street 1:5810 SOUTHWYCK BLVD STE 101A
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1518
Practice Address - Country:US
Practice Address - Phone:567-315-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty