KEYSTONE COMMUNITY LIVING, INC. (NPI# 1487034112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487034112 |
| Entity Type | Organization |
| Organization Name | KEYSTONE COMMUNITY LIVING, INC. |
| Practice Address |
27 Brandywine Cir Piscataway NJ 08854-2704 |
| Mailing Address |
154 Front St South Plainfield NJ 07080-3402 |
| Practice Telephone | 9087571080 |
| Practice Fax Number | 9087556810 |
| Mailing Telephone | 9087571080 |
| Mailing Fax Number | 9087556810 |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2018-01-10 |
| Authorized Official Name | RAY FANTUZZI (PRESIDENT) |
| Authorized Official Telephone | 9087571080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184189037 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 31 Brookside Ave Apt 2a, Somerville, NJ 08876-5609 | 2019-02-05 |
| 1861972549 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21 Brookside Ave Apt 2b, Somerville, NJ 08876-5607 | 2018-08-21 |
| 1326528001 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 40 Brookside Ave Apt 11a, Somerville, NJ 08876-5600 | 2018-08-21 |
| 1609383793 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 20 Gramercy Gdns, Middlesex, NJ 08846-1686 | 2018-01-10 |
| 1376050443 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 44 Fairmount Ave, Bridgewater, NJ 08807-3156 | 2018-01-10 |
| 1275040354 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 503 Rockview Ave, North Plainfield, NJ 07063-1812 | 2018-01-10 |
| 1518474600 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 54 Gramercy Gdns, Middlesex, NJ 08846-1687 | 2018-01-10 |
| 1427565522 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 72 Gramercy Gdns, Middlesex, NJ 08846-1687 | 2018-01-10 |
| 1497262596 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1218 Brookside Rd, Piscataway, NJ 08854-5119 | 2018-01-10 |
| 1528575610 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11 Brookside Ave Apt 6a, Somerville, NJ 08876-5605 | 2018-01-10 |
| Street Address |
27 BRANDYWINE CIR |
| City | PISCATAWAY |
| State | NJ |
| Zip Code | 08854-2704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992327548 | Sally Ng | Student in an Organized Health Care Education/Training Program | 675 Hoes Lane West, Piscataway, NJ 08854 | 2020-05-16 |
| 1932728870 | Mawaddah Ahmed Mohamed Khalil Alislambouli | Student in an Organized Health Care Education/Training Program | 1701 Quincy Street, Piscataway, NJ 08854 | 2020-04-10 |
| 1457831273 | Lindsay Brooke Gonzalez | Social Worker | Rutgers Day School- Rutgers University Ubhc, 671 Hoes Lane, Piscataway, NJ 08854 | 2018-08-21 |
| 1568941524 | Step Three Support Services, LLC | In Home Supportive Care | 1297 Centennial Ave Ste 5-102, Piscataway, NJ 08854 | 2018-08-10 |
| 1942788252 | Adrienne Wallace | Speech-Language Pathologist | 170 Birchview Dr, Piscataway, NJ 08854 | 2018-07-31 |
| 1215423066 | Eugene Reid | Physical Medicine & Rehabilitation | 250 Old New Brunswick Road, Building 12, Piscataway Township, NJ 08854 | 2018-07-05 |
| 1649768326 | Madhusree Chowdhury | Student in an Organized Health Care Education/Training Program | Rutgers Rwjms, 675 Hoes Lane, Piscataway, NJ 08854 | 2018-04-27 |
| 1033635065 | Achieving Goals, LLC | Community Health Worker | 83 Kensington Drive, Piscataway, NJ 08854 | 2017-08-22 |
| 1750801650 | Neil O'connor | Case Manager/Care Coordinator | 151 Centenial Ave, Piscataway, NJ 08854 | 2017-06-21 |
| 1235680240 | Manthan Patel | Pharmacist | 1222 Hanover St, Piscataway, NJ 08854 | 2016-10-14 |
| Find all providers in zip 08854 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497262596 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1218 Brookside Rd, Piscataway, NJ 08854-5119 | 2018-01-10 |
| 1982121737 | The Arc Middlesex County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 226 Pleasantview Dr Apt A, Piscataway, NJ 08854-3405 | 2017-08-23 |
| 1780100495 | The Arc Middlesex County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 74 Old New Brunswick Rd Apt C, Piscataway, NJ 08854-3886 | 2017-08-15 |
| 1205363512 | Everas Community Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 30 Seward Ave, Piscataway, NJ 08854-4233 | 2017-05-17 |
| 1669908240 | New Jersey Institute for Disabilities, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 380 Hamilton Blvd, Piscataway, NJ 08854-2813 | 2017-05-03 |
| 1285169342 | Everas Community Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1207 Charter St, Piscataway, NJ 08854-3309 | 2017-04-26 |
| 1770939589 | Dungarvin New Jersey, LLC-kilmer | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 311 Kilmer Ct, Piscataway, NJ 08854 | 2016-05-11 |
| 1174979983 | Dungarvin New Jersey, LLC-cedarwood | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1701 Cedarwood Dr, Piscataway, NJ 08854 | 2016-05-11 |
| 1497101331 | Dungarvin New Jersey, LLC-ross Hall | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 68 Ross Hall Blvd N, Piscataway, NJ 08854 | 2016-05-10 |
| 1700267903 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 82 Curtis Ave, Piscataway, NJ 08854-1965 | 2015-06-12 |
| Find all providers in PISCATAWAY | ||||
| City | PISCATAWAY |
| Zip Code | 08854 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.