Provider Demographics
NPI:1871176016
Name:KELLER LEASING CO, LLC
Entity type:Organization
Organization Name:KELLER LEASING CO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-489-7100
Mailing Address - Street 1:4700 ASHWOOD DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2424
Mailing Address - Country:US
Mailing Address - Phone:513-489-7100
Mailing Address - Fax:
Practice Address - Street 1:7450 KELLER RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243-1028
Practice Address - Country:US
Practice Address - Phone:513-793-2255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility