KEYSTONE COMMUNITY RESOURCES, INC. (NPI# 1669953642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669953642 |
| Entity Type | Organization |
| Organization Name | KEYSTONE COMMUNITY RESOURCES, INC. |
| Practice Address |
767 State Route 307 Spring Brook Township PA 18444-6463 |
| Mailing Address |
100 Abington Executive Park Ste B Clarks Summit PA 18411-2276 |
| Practice Telephone | 5708429395 |
| Mailing Telephone | 5707028000 |
| Mailing Fax Number | 5707028196 |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2020-02-07 |
| Authorized Official Name | MR. DAVID ANTHONY DAVITT (ACCOUNTS RECEIVABLE COORDINATOR) |
| Authorized Official Telephone | 5707028000 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | CER-00128996 | PA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568094142 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1768 Mcdonough Ave, Scranton, PA 18508-1566 | 2020-02-11 |
| 1114559267 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 336 Sheridan Ave, Clarks Summit, PA 18411-1458 | 2020-02-06 |
| 1902363005 | Keystone Community Resources, Inc. | Day Training/Habilitation Specialist | 628 Genet Street, Scranton, PA 18505 | 2019-02-25 |
| 1689131997 | Keystone Community Resources, Inc. | Community/Behavioral Health | 100 Abington Executive Park Ste B, Clarks Summit, PA 18411-2276 | 2019-02-22 |
| 1245714757 | Keystone Community Resources, Inc. | Day Training/Habilitation Specialist | 921 Penn Ave, Scranton, PA 18509-2901 | 2018-09-20 |
| 1861976383 | Keystone Community Resources, Inc. | Day Training/Habilitation Specialist | 1729 Pittston Ave, Scranton, PA 18505-4514 | 2018-09-20 |
| 1508340027 | Keystone Community Resources, Inc. | Day Training/Habilitation Specialist | 628 Genet Streeet, Scranton, PA 18505-1165 | 2018-09-20 |
| 1891279303 | Keystone Community Resources, Inc. | Day Training/Habilitation Specialist | 1501 Sanderson Ave, Scranton, PA 18509-2258 | 2018-09-20 |
| 1467936948 | Keystone Community Resources, Inc. | Day Training/Habilitation Specialist | 2100 Route 6 and 11, Laplume, PA 18440 | 2018-09-20 |
| 1629552252 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21 Joni Dr, Moscow, PA 18444-6303 | 2018-09-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | KEYSTONE COMMUNITY RESOURCES, INC. | 100 Abington Executive Park, Clarks Summit, PA 18411-2260 |
| Street Address |
767 STATE ROUTE 307 |
| City | SPRING BROOK TOWNSHIP |
| State | PA |
| Zip Code | 18444-6463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285949370 | Susan D Decesare | Psychologist | 260 Daleville Highway, Suite 105, Covington Township, PA 18444 | 2010-08-12 |
| 1487986741 | Rocco G. Diana | Chiropractor | 1186 Church St., Moscow, PA 18444 | 2010-02-10 |
| 1821263666 | Jay Joseph Sochoka | Pharmacist | Routes 435 & 502, Moscow, PA 18444 | 2008-04-23 |
| 1669671004 | Donald W Haines | Dentist | 921 Drinker Turnpike, Suite 19, Coventry Township, PA 18444 | 2007-07-16 |
| 1952422750 | James Steven Fagan | Dentist | 1644 Rt 611 Fountain Springs West, Suite 3, Tannersville, PA 18444 | 2007-04-02 |
| 1184728313 | Braceys Supermarket Inc. | Pharmacy | Route 502, Daleville, PA 18444 | 2006-09-08 |
| 1720003254 | Antony L Graham | Chiropractor | 1186 Church Street, Moscow, PA 18444 | 2006-07-13 |
| 1245228410 | Jose Aramburo | Family Medicine | Rt 502 Box 6239, Moscow, PA 18444 | 2005-10-11 |
| 1225305311 | Kimberly A. Desau | Occupational Therapist | 516 Saint Marys Villa Rd, Elmhurst Township, PA 18444 | 2011-11-17 |
| 1962680413 | Dr Richard Margerum Optometrist | Optometrist | 328 N Main St, Moscow, PA 18444 | 2008-02-07 |
| Find all providers in zip 18444 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649887514 | Thakker & Amin LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 91 N York Rd Apt 400-09, Willow Grove, PA 19090-2155 | 2020-09-25 |
| 1104463736 | Embolden Community Allies | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4000 Gypsy Ln Unit 204, Philadelphia, PA 19129-5405 | 2019-12-02 |
| 1528605243 | United Care Community Home LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1201 Overlook Rd Apt 6, Whitehall, PA 18052-6124 | 2019-12-01 |
| 1326684010 | Active Community Support | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3505 W Moreland Rd, Willow Grove, PA 19090-3831 | 2019-11-18 |
| 1851851083 | A Sun Starr Independent Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1673 Suburban Ave, Pittsburgh, PA 15216-3722 | 2019-03-22 |
| 1477031029 | Biacon Family and Community Support Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 205 Pennford Pl, Garnet Valley, PA 19060-2407 | 2018-08-04 |
| 1134623515 | Woods Services Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 361 South Bellevue Avenue, Langhorne, PA 19047 | 2018-03-21 |
| 1518470624 | Cdig Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1714 Danforth St, Philadelphia, PA 19152-1802 | 2017-11-10 |
| 1619488434 | Creative Dialogues, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 828 Renier Ave, Turtle Creek, PA 15145-1608 | 2017-10-19 |
| 1699285676 | Antonio Romero | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1045 N Leithgow St, Philadelphia, PA 19123-1420 | 2017-10-04 |
| Find all providers with the same taxonomy | ||||
| City | SPRING BROOK TOWNSHIP |
| Zip Code | 18444 |
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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.