KEYSTONE COMMUNITY RESOURCES, INC. (NPI# 1003390642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003390642 |
| Entity Type | Organization |
| Organization Name | KEYSTONE COMMUNITY RESOURCES, INC. |
| Practice Address |
511 Stafford Ave Scranton PA 18505-2131 |
| Mailing Address |
100 Abington Executive Park Ste B Clarks Summit PA 18411-2276 |
| Practice Telephone | 5709692262 |
| Mailing Telephone | 5707028000 |
| Mailing Fax Number | 5707028196 |
| Enumeration Date | 2018-09-19 |
| 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 |
511 STAFFORD AVE |
| City | SCRANTON |
| State | PA |
| Zip Code | 18505-2131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952927998 | Gary Chee Seng Oh | Student in an Organized Health Care Education/Training Program | 501 S. Washintgon Avenue, Scranton, PA 18505 | 2020-06-24 |
| 1851915813 | Usman Amjia Manzoor | Student in an Organized Health Care Education/Training Program | 501 South Washintgon Avenue, Scranton, PA 18505 | 2020-06-04 |
| 1396368791 | Navharsh Kaur Sekhon | Student in an Organized Health Care Education/Training Program | 501 S, Washington Avenue, Scranton, PA 18505 | 2020-05-20 |
| 1275154395 | Yamini Indravadan Patel | Student in an Organized Health Care Education/Training Program | 501 South Washington Avenue The Wright Center for Gradu, 501 South Washington Avenue, Scranton, PA 18505 | 2020-04-29 |
| 1225659584 | Raza Naseer | Student in an Organized Health Care Education/Training Program | 501 S. Washington Avenue, Scranton, PA 18505 | 2020-04-28 |
| 1932720307 | Mohammad Asim Amjad | Student in an Organized Health Care Education/Training Program | 501 South Washington Avenue, Scranton, PA 18505 | 2020-04-27 |
| 1033739404 | Amina Khan | Student in an Organized Health Care Education/Training Program | 501 S Washington Avenue, Scranton, PA 18505 | 2020-04-25 |
| 1245862259 | Princy Kanakkumar Shah | Internal Medicine | Wright Medical Center, 501 S Washington Avenue, Scranton, PA 18505 | 2020-02-07 |
| 1902363005 | Keystone Community Resources, Inc. | Day Training/Habilitation Specialist | 628 Genet Street, Scranton, PA 18505 | 2019-02-25 |
| 1629596242 | Morgan Aubrey Yackey | Social Worker | 1509 Maple St., Scranton, PA 18505 | 2017-09-04 |
| Find all providers in zip 18505 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1619451259 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 18 Leslie Dr, Scranton, PA 18505-2216 | 2018-09-19 |
| 1821572462 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 332 S 9th Ave, Scranton, PA 18504-2602 | 2018-09-19 |
| 1023592664 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 102 Pequest Dr, Scranton, PA 18505-3627 | 2018-09-19 |
| 1932683570 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 815 Orchard St, Scranton, PA 18505-2027 | 2018-09-19 |
| 1306320940 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 917 Orchard St, Scranton, PA 18505-2117 | 2018-09-19 |
| 1326522962 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 101 Marjorie Dr, Scranton, PA 18505-2217 | 2018-09-19 |
| 1861976409 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1807 N Main Ave, Scranton, PA 18508-1944 | 2018-09-19 |
| 1194209858 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2337 Shawnee Ave, Scranton, PA 18509-1343 | 2018-09-19 |
| 1669956207 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 925 Stafford Ave, Scranton, PA 18505-2529 | 2018-09-19 |
| Find all providers in SCRANTON | ||||
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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.