Keller Care Lmft
PACE Provider Organization in Roseville, CA. Organization (NPI-2).
NPI number1760106744
StatusActive
Last updated in NPPESOct 3, 2022
Details
- NPI
- 1760106744
- Entity type
- Organization (NPI-2)
- Legal business name
- Keller Care Lmft
- Organization subpart
- No
- Enumeration date
- Oct 3, 2022
- Certification date
- Oct 3, 2022
- Last updated
- Oct 3, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251T00000X | PACE Provider Organization | – | – | Yes |
Practice location
901 Sunrise Ave.Suite A3
Roseville, CA 95661
Phone 279-219-9529
Mailing address
700 Gibson Dr Apt 1713Roseville, CA 95678-5762
Phone 279-219-9529
Authorized official
Julie Anna Keller
Owner
2792199529
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