Provider Demographics
NPI:1821613373
Name:KEYS DEVELOPMENT TA
Entity Type:Organization
Organization Name:KEYS DEVELOPMENT TA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:TRACEY
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-429-2536
Mailing Address - Street 1:7501 LIBERTY RD STE F/G
Mailing Address - Street 2:KEYS DEVELOPMENT TA LLC.
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207
Mailing Address - Country:US
Mailing Address - Phone:443-429-2536
Mailing Address - Fax:443-316-8290
Practice Address - Street 1:7501 LIBERTY RD STE F/G
Practice Address - Street 2:KEYS DEVELOPMENT TA LLC.
Practice Address - City:GWYNN OAK
Practice Address - State:MD
Practice Address - Zip Code:21207
Practice Address - Country:US
Practice Address - Phone:443-429-2536
Practice Address - Fax:443-316-8290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management