Organization
KELLIS HOME LLC
Active
Other names
Kellis Home LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA L KELLIS (DIRECTOR OF OPERATIONS)
(937) 403-4051
Entity
Organization
Contact information
Practice address
404 SOUTH ST, GREENFIELD, OH 45123-1432
(937) 403-4051
Mailing address
404 SOUTH ST, GREENFIELD, OH 45123-1432
(937) 403-4051
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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