Provider Demographics
NPI:1124661608
Name:KEY TO LIFE HOMECARE INC.
Entity type:Organization
Organization Name:KEY TO LIFE HOMECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GVANTSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMISHVILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-704-0494
Mailing Address - Street 1:2657 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3915
Mailing Address - Country:US
Mailing Address - Phone:347-704-0494
Mailing Address - Fax:347-704-7336
Practice Address - Street 1:2657 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3915
Practice Address - Country:US
Practice Address - Phone:347-704-0494
Practice Address - Fax:347-704-7336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health