Provider Demographics
NPI:1821770694
Name:KEADEE EMERGENCY MINISTRIES INTERVENTION
Entity Type:Organization
Organization Name:KEADEE EMERGENCY MINISTRIES INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAJIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-313-6013
Mailing Address - Street 1:13119 FENNWAY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7160
Mailing Address - Country:US
Mailing Address - Phone:813-313-6013
Mailing Address - Fax:
Practice Address - Street 1:13119 FENNWAY RIDGE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7160
Practice Address - Country:US
Practice Address - Phone:813-313-6013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Single Specialty
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Single Specialty