NPIMap

Organization Active NPI

Keystone Community Living, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Somerville, NJ
National Provider Identifier
1255848347
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
KEYSTONE COMMUNITY LIVING, INC.
Practice address
21 Brookside Ave Apt 6a
Somerville, NJ 08876-5607
Phone
(908) 334-3777
NPI assigned
Jan 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ray Fantuzzi
Title
President
Phone
(908) 757-1080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

21 Brookside Ave Apt 6a
Somerville, NJ 08876-5607

Mailing address

154 Front St
South Plainfield, NJ 07080-3402
Phone (908) 757-1080

National Provider Directory

National Provider Directory
Tax ID family
Keystone Community Living Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1255848347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 FRONT ST",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070803402",
            "telephone_number": "908-757-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BROOKSIDE AVE APT 6A",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088765607",
            "telephone_number": "908-334-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE COMMUNITY LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "FANTUZZI",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-757-1080"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.