Provider Demographics
NPI:1922663996
Name:KEY HOME CARE AGENCY
Entity Type:Organization
Organization Name:KEY HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAKEYLA
Authorized Official - Middle Name:AMBRIEL
Authorized Official - Last Name:CARLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-779-0633
Mailing Address - Street 1:1900 RICE MINE RD N APT 411
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2344
Mailing Address - Country:US
Mailing Address - Phone:678-779-0633
Mailing Address - Fax:
Practice Address - Street 1:1900 RICE MINE RD N APT 411
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2344
Practice Address - Country:US
Practice Address - Phone:678-779-0633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No174200000XOther Service ProvidersMeals
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty