Provider Demographics
NPI:1942223938
Name:KEYS OF LIFE PROFESSIONAL CARE SERVICES, INC.
Entity Type:Organization
Organization Name:KEYS OF LIFE PROFESSIONAL CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WORK
Authorized Official - Phone:504-340-1119
Mailing Address - Street 1:6700 LAPALCO BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4590
Mailing Address - Country:US
Mailing Address - Phone:504-340-1119
Mailing Address - Fax:504-340-1159
Practice Address - Street 1:6700 LAPALCO BLVD STE A
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-4590
Practice Address - Country:US
Practice Address - Phone:504-340-1119
Practice Address - Fax:504-340-1159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA10206Medicaid