Provider Demographics
NPI:1922739705
Name:KEYAIRA GIFTS & TALENTS FOUNDATION
Entity Type:Organization
Organization Name:KEYAIRA GIFTS & TALENTS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPER
Authorized Official - Suffix:
Authorized Official - Credentials:DD,LSW,MSW, CADC,
Authorized Official - Phone:708-864-1684
Mailing Address - Street 1:3850 DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-2563
Mailing Address - Country:US
Mailing Address - Phone:708-864-1684
Mailing Address - Fax:
Practice Address - Street 1:3850 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-2563
Practice Address - Country:US
Practice Address - Phone:708-864-1684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health