1265557961 NPI number — KEY HUMAN SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265557961 NPI number — KEY HUMAN SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KEY HUMAN SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265557961
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1290 SILAS DEANE HWY
Provider Second Line Business Mailing Address:
SUITE 1A
Provider Business Mailing Address City Name:
WETHERSFIELD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06109-4337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-409-7350
Provider Business Mailing Address Fax Number:
860-757-3674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1290 SILAS DEANE HWY
Provider Second Line Business Practice Location Address:
SUITE 1A
Provider Business Practice Location Address City Name:
WETHERSFIELD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06109-4337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-409-7350
Provider Business Practice Location Address Fax Number:
860-757-3674
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KOVITCH
Authorized Official First Name:
MARK
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
860-409-7350

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 252Y00000X , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 004185949 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com