Provider Demographics
NPI:1063219608
Name:KEE, KELA
Entity type:Individual
Prefix:
First Name:KELA
Middle Name:
Last Name:KEE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 W BROAD ST STE 210
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43222-1471
Mailing Address - Country:US
Mailing Address - Phone:614-407-1771
Mailing Address - Fax:614-334-5078
Practice Address - Street 1:775 W BROAD ST STE 210
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1471
Practice Address - Country:US
Practice Address - Phone:614-407-1771
Practice Address - Fax:614-334-5078
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator