Provider Demographics
NPI:1457100604
Name:KEEN IN CARE LLC
Entity type:Organization
Organization Name:KEEN IN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-805-1741
Mailing Address - Street 1:340 S MONTE VISTA ST APT B
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-9066
Mailing Address - Country:US
Mailing Address - Phone:562-805-1741
Mailing Address - Fax:
Practice Address - Street 1:8301 CLEARWATER CT
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-6116
Practice Address - Country:US
Practice Address - Phone:619-292-2023
Practice Address - Fax:619-872-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-17
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization