NPIMap

Organization Active NPI

Keys Development Ta LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gwynn Oak, MD
National Provider Identifier
1578095618
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
KEYS DEVELOPMENT TA LLC
Practice address
7501 Liberty Road
Suites a, B, F/G & L
Gwynn Oak, MD 21207-3870
Phone
(443) 429-2536
Fax
(443) 429-2168
NPI assigned
Mar 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erika Tracey Robinson
Title
Director of Operations
Phone
(443) 429-2536

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MH-1995 MD
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

7501 Liberty Road
Suites a, B, F/G & L
Gwynn Oak, MD 21207-3870

Mailing address

7501 Liberty Road
Suites a, B, F/G & L
Gwynn Oak, MD 21207-3870
Phone (443) 429-2536

Other identifiers 2

IdentifierTypeStateIssuer
4235077000MedicaidMD
4233169400MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Keys Development Ta LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7501 Liberty Rd
Ste A
Gwynn Oak, MD 21207
Phone (443) 429-2536

7501 Liberty Rd
Ste F
Gwynn Oak, MD 21207

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1578095618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 LIBERTY ROAD",
            "address_2": "SUITES A, B, F/G & L",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212073870",
            "telephone_number": "443-429-2536",
            "fax_number": "443-429-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 LIBERTY ROAD",
            "address_2": "SUITES A, B, F/G & L",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212073870",
            "telephone_number": "443-429-2536",
            "fax_number": "443-429-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYS DEVELOPMENT TA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_middle_name": "TRACEY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "443-429-2536"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "MH-1995",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4235077000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4233169400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gwynn Oak, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.