Provider Demographics
NPI:1780997254
Name:KEYESE HOME CARE LLC
Entity type:Organization
Organization Name:KEYESE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:KEISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-402-0491
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-0218
Mailing Address - Country:US
Mailing Address - Phone:443-402-0491
Mailing Address - Fax:
Practice Address - Street 1:1900 WALTMAN RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-2338
Practice Address - Country:US
Practice Address - Phone:443-402-0491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health