KEYSTONE COMMUNITY RESOURCES, INC. (NPI# 1114559267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114559267 |
| Entity Type | Organization |
| Organization Name | KEYSTONE COMMUNITY RESOURCES, INC. |
| Practice Address |
336 Sheridan Ave Clarks Summit PA 18411-1458 |
| Mailing Address |
100 Abington Executive Park Ste B Clarks Summit PA 18411-2276 |
| Practice Telephone | 5703191482 |
| Practice Fax Number | 5707028096 |
| Mailing Telephone | 5707028000 |
| Mailing Fax Number | 5707028096 |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0598747 | 05 | |
| PA | 100001010 | 05 |
| 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 |
| 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 |
| 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 |
| 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 |
336 SHERIDAN AVE |
| City | CLARKS SUMMIT |
| State | PA |
| Zip Code | 18411-1458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881228153 | Hayley Nicole Zelinka | Physical Therapist | 1000 Edella Road, South Abington, PA 18411 | 2020-02-26 |
| 1023657269 | Erica Lynn Bednarz | Physical Therapist | 1001 Scenic Drive, Clarks Summit, PA 18411 | 2020-01-06 |
| 1386298842 | Gj-mac Enterprises LLC | In Home Supportive Care | 506 N State Street, Clarks Summit, PA 18411 | 2019-08-01 |
| 1609392117 | Colleen Marie Dougherty | Nurse Practitioner | 1145 Northern Boulevard, South Abington, PA 18411 | 2017-08-16 |
| 1629438312 | Christopher Oyede | Psychiatry & Neurology | 1508 Applewood Acres, South Abington, Clarks Summit, PA 18411 | 2016-02-24 |
| 1194107326 | Russell Zapko | Physical Medicine & Rehabilitation | 100 Edella Road, South Abington, PA 18411 | 2015-06-24 |
| 1952719619 | Geisinger Clinic | Family Medicine | 790 North Blvd, Suite K, Clarks Summit, PA 18411 | 2014-07-25 |
| 1437428182 | Gloria Marie Gigliotti | Behavioral Analyst | 718 South State Street, Caregivers of America, Clsarks Summit, PA 18411 | 2011-12-27 |
| 1790064137 | John D Cacciamani | Internal Medicine | 1345 Glenview Rd., Clarks Summit, PA 18411 | 2011-08-16 |
| 1235372418 | Five Star Quality Care-ghv, LLC | Assisted Living Facility | 950 Morgan Highway, Clarks Summit, PA 18411 | 2009-04-17 |
| Find all providers in zip 18411 | ||||
| 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 |
|---|---|---|---|---|
| 1770124588 | Keystone Independent Living Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 320 Tulip Cir, Clarks Summit, PA 18411-2134 | 2019-10-02 |
| 1861033151 | Keystone Independent Living Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 100 Abington Executive Park Ste B, Clarks Summit, PA 18411-2276 | 2019-10-08 |
| 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 |
| 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 |
| 1922643824 | Community Options, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 137 Mathews St Ste 1500, Greensburg, PA 15601-6940 | 2019-11-14 |
| Find all providers with the same taxonomy | ||||
| City | CLARKS SUMMIT |
| Zip Code | 18411 |
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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.