KEYSTONE COMMUNITY RESOURCES, INC. (NPI# 1902380793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902380793 |
| Entity Type | Organization |
| Organization Name | KEYSTONE COMMUNITY RESOURCES, INC. |
| Practice Address |
506 Lincoln Ave Jermyn PA 18433-1632 |
| Mailing Address |
100 Abington Executive Park Ste B Clarks Summit PA 18411-2276 |
| Practice Telephone | 5708765056 |
| Mailing Telephone | 5707028000 |
| Mailing Fax Number | 5707028196 |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2020-02-07 |
| Authorized Official Name | MR. DAVID ANTHONY DAVITT JR. (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 | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 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 |
506 LINCOLN AVE |
| City | JERMYN |
| State | PA |
| Zip Code | 18433-1632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265918940 | Andrew Brown's Drug Store, Inc. | Pharmacy | 5 Washington Ave, Suite One, Jermyn, PA 18433 | 2018-07-16 |
| 1538615380 | Peterjason Ligi | Dietitian, Registered | 122 5th St, Mayfield, PA 18433 | 2016-08-31 |
| 1215059001 | Patrick Thomas Hayes | Dentist | 314 Rushbrook St, Jermyn, PA 18433 | 2007-04-04 |
| 1033252523 | Sterling Pharmacy,inc. | Pharmacy | 547 Washington Ave, Jermyn, PA 18433 | 2007-02-14 |
| 1710090824 | Nancy Greer | Nurse Practitioner | 5 S Washington Avenue, Jermyn, PA 18433 | 2006-08-16 |
| 1164439006 | Scranton Temple Residency Program Faculty Service | Internal Medicine | 5 S. Washington Ave, Jermyn, PA 18433 | 2006-08-02 |
| 1205892999 | Bhupendra Rambhai Patel Sr. | Internal Medicine | 512 Lackawanna Avenue, Mayfield, PA 18433 | 2006-04-22 |
| 1336639244 | Vitz Medical LLC | Clinic/Center | 504 1/2 Scranton Carbondale Hwy, Mayfield, PA 18433 | 2018-05-16 |
| 1164774261 | Theresa Micknick | Physician Assistant | 165 Fallbrook St, Carbondale, PA 18433 | 2012-10-12 |
| 1043522402 | Jumee Barooah | Internal Medicine | 5 S Washington Ave, Jermyn, PA 18433 | 2010-07-13 |
| Find all providers in zip 18433 | ||||
| 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 |
|---|---|---|---|---|
| 1356940183 | Kenccid | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9350 Ashton Rd Rm 202, Philadelphia, PA 19114-7402 | 2020-10-22 |
| 1952908618 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 604 Glen Circle Dr, Tobyhanna, PA 18466-8300 | 2020-10-06 |
| 1598375305 | Impactful Human Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1055 Westlakes Dr Ste 3003, Berwyn, PA 19312-2410 | 2020-08-06 |
| 1356969679 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 100 Genuardi Circle, West Chester, PA 19380 | 2020-07-13 |
| 1437775442 | The Arc of Crawford County, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 222 Chestnut St, Meadville, PA 16335-3407 | 2020-06-25 |
| 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 |
| 1619507332 | Above & Beyond Berks LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1007 Saylor Dr, Temple, PA 19560-9587 | 2020-01-22 |
| 1700425287 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 639 N South Turnpike Rd, Newfoundland, PA 18445-5032 | 2019-12-31 |
| 1891331120 | Gifted Hands Home Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1853 William Penn Way Ste 13, Lancaster, PA 17601-6713 | 2019-11-21 |
| Find all providers with the same taxonomy | ||||
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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.