Provider Demographics
NPI:1821335613
Name:KEY REHABILITATION,INC.
Entity Type:Organization
Organization Name:KEY REHABILITATION,INC.
Other - Org Name:GEROPSYCH, A DIVISION OF KEY REHABILITATION, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:S
Authorized Official - Last Name:IRWIND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-896-6400
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:615-896-6400
Mailing Address - Fax:615-896-5177
Practice Address - Street 1:35625 HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MO
Practice Address - Zip Code:65560-7217
Practice Address - Country:US
Practice Address - Phone:573-729-6141
Practice Address - Fax:615-896-5177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA4467Medicare Oscar/Certification
MODU1782Medicare Oscar/Certification