Organization
KEYS TO SUCCESS RECOVERY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEEYANNA CROCKETT (OWNER)
(614) 927-9325
Entity
Organization
Contact information
Practice address
3313 RAYNOR DR, COLUMBUS, OH 43219-3256
(614) 507-5908
Mailing address
3313 RAYNOR DR, COLUMBUS, OH 43219-3256
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
11/17/2022
Last updated
12/16/2022
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