Provider Demographics
NPI:1366253932
Name:KESHIA LEE ESTATE
Entity type:Organization
Organization Name:KESHIA LEE ESTATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:KESHIA
Authorized Official - Last Name:MARIE
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:269-419-3752
Mailing Address - Street 1:1121 MILLER RD STE 3612
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-9998
Mailing Address - Country:US
Mailing Address - Phone:269-910-0958
Mailing Address - Fax:
Practice Address - Street 1:726 EGLESTON AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001
Practice Address - Country:US
Practice Address - Phone:269-419-3752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health