Provider Demographics
NPI:1649395583
Name:KEY PROGRAM, INC.
Entity Type:Organization
Organization Name:KEY PROGRAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-861-2680
Mailing Address - Street 1:670 OLD CONNECTICUT PATH
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4548
Mailing Address - Country:US
Mailing Address - Phone:508-877-3690
Mailing Address - Fax:
Practice Address - Street 1:623 ATWELLS AVE
Practice Address - Street 2:SUITE 201-D
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-7403
Practice Address - Country:US
Practice Address - Phone:401-861-2680
Practice Address - Fax:401-751-6641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI251S00000X, 322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Not Answered322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children