| Keys Development Ta Llc | |
|
7501 Liberty Road Suites A, B, F/g & L Gwynn Oak MD 21207-3870 | |
| (443) 429-2536 | |
| (443) 429-2168 |
| Full Name | Keys Development Ta Llc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 7501 Liberty Road, Gwynn Oak, Maryland |
| Authorized Official Name and Position | Erika Tracey Robinson (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 4434292536 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keys Development Ta Llc 7501 Liberty Road Suites A, B, F/g & L Gwynn Oak MD 21207-3870 Ph: (443) 429-2536 | Keys Development Ta Llc 7501 Liberty Road Suites A, B, F/g & L Gwynn Oak MD 21207-3870 Ph: (443) 429-2536 |
| NPI Number | 1578095618 |
|---|---|
| Provider Enumeration Date | 03/29/2017 |
| Last Update Date | 04/24/2023 |
| Certification Date | 04/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578095618 | NPI | - | NPPES |
| 4235077000 | Medicaid | MD | |
| 4233169400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MH-1995 (Maryland) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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