KEYSTONE COMMUNITY LIVING, INC. (NPI# 1992212070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992212070 |
| Entity Type | Organization |
| Organization Name | KEYSTONE COMMUNITY LIVING, INC. |
| Practice Address |
40 Brookside Ave Apt 1b Somerville NJ 08876-5610 |
| Mailing Address |
154 Front St South Plainfield NJ 07080-3402 |
| Practice Telephone | 9083343777 |
| Mailing Telephone | 9087571080 |
| Enumeration Date | 2018-01-10 |
| 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 |
40 BROOKSIDE AVE APT 1B |
| City | SOMERVILLE |
| State | NJ |
| Zip Code | 08876-5610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730728999 | Christine Paige Robbins | Speech-Language Pathologist | 21 E High St, 2nd Floor, Somerville, NJ 08876 | 2020-01-04 |
| 1043861339 | County of Somerset | Public Health or Welfare | 27 Warren Street, 3rd Floor, Somerville, NJ 08876 | 2019-09-27 |
| 1275098840 | Ruth Leslie Goldsmith | Social Worker | 134 W End Ave Fl 2, Somerville, NJ 08876 | 2019-02-07 |
| 1114417524 | Dae Kim | Student in an Organized Health Care Education/Training Program | Somerset Family Practice, 110 Rehill Avenue, Somerville, NJ 08876 | 2018-05-11 |
| 1881195881 | Fisayo Tunde | Obstetrics & Gynecology | 3322 Us Highway 22 Ste 1302, Branchburg, NJ 08876 | 2018-02-24 |
| 1972026268 | Deirdre Mccarthy | Physical Therapist | 18 Sunset St., Branchburg, NJ 08876 | 2017-07-19 |
| 1649719964 | Alternatives, Inc. | Community/Behavioral Health | 85-87 Fairview Ave., Somerville, NJ 08876 | 2017-02-20 |
| 1083153308 | Jing Acupuncture Service LLC | Acupuncturist | 3322 Us Highway 22, Bldg 8, 805, Branchburg, NJ 08876 | 2017-02-20 |
| 1326590548 | Physicians Dialysis Somerville, LLC | Clinic/Center | 1 Route 206, North, Somerville, NJ 08876 | 2016-11-04 |
| 1548501679 | Bilal Mian Md Pa | Psychiatry & Neurology | 310 East Mian St, Somerville, NJ 08876 | 2013-03-14 |
| Find all providers in zip 08876 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 1255848347 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21 Brookside Ave Apt 6a, Somerville, NJ 08876-5607 | 2018-01-10 |
| 1437666518 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 40 Brookside Ave Apt 7b, Somerville, NJ 08876-5610 | 2018-01-10 |
| 1164939245 | Keystone Community Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 60 Brookside Ave Apt 9b, Somerville, NJ 08876-5613 | 2018-01-10 |
| 1013444710 | Everas Community Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Imperial Dr, Somerville, NJ 08876-1718 | 2017-05-12 |
| 1861926826 | Center for Family Support, New Jersey, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 222 Union Ave, Somerville, NJ 08876-2621 | 2017-04-17 |
| 1437530458 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 90 Brookside Ave Apt 7b, Somerville, NJ 08876-5618 | 2015-06-16 |
| Find all providers in SOMERVILLE | ||||
| City | SOMERVILLE |
| Zip Code | 08876 |
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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.