Provider Demographics
NPI:1265120489
Name:KEY PIECES THERAPY LLC
Entity type:Organization
Organization Name:KEY PIECES THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-789-7239
Mailing Address - Street 1:2681 HIGHWAY 15
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:LA
Mailing Address - Zip Code:71225-8151
Mailing Address - Country:US
Mailing Address - Phone:318-789-7239
Mailing Address - Fax:866-819-6912
Practice Address - Street 1:1701 OLD MINDEN RD STE 21
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-4846
Practice Address - Country:US
Practice Address - Phone:318-408-1664
Practice Address - Fax:318-588-7813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty