Provider Demographics
NPI:1427804319
Name:KEYLA KARES CORP
Entity type:Organization
Organization Name:KEYLA KARES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-537-1333
Mailing Address - Street 1:1608 BRIARVIEW CT
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-4410
Mailing Address - Country:US
Mailing Address - Phone:301-537-1333
Mailing Address - Fax:
Practice Address - Street 1:702 MELVILLE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2553
Practice Address - Country:US
Practice Address - Phone:301-537-1333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child