Keystone Independent Living

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

226650 Issued in PA

Legal business name

KEYSTONE INDEPENDENT LIVING

Practice address

202 Boulevard Ave
Peckville, PA 18452-1002

Phone

(570) 307-4067

NPI assigned

Feb 4, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Robert Fleese

Title

President/Owner

Phone

(570) 702-8104

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1689913196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ABINGTON EXECUTIVE PARK",
            "address_2": "SUITE B",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184112260",
            "telephone_number": "570-702-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 BOULEVARD AVE",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "184521002",
            "telephone_number": "570-307-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE INDEPENDENT LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "FLEESE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "570-702-8104",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "PA",
            "license": "226650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Lynn Hunsinger, MS, LAPC, NCC
• Jeffrey G Rieder DPM
• Jennifer Wascura LCSW, LLC
• John F Bushta DPM PC
• Joseph R. Loiacono Jr. DDS,PC
• Deanna Elizabeth Kilmer, KILMER, DEANNA PTA
• Andrew Knott
• Jason Kurilla
• Joseph R Loracono Jr., DDS
• Ryan Kevin Loughran

• Adult Care Home Facility in Peckville, PA
• Providers in Peckville, PA by specialty
• Adult Care Home Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.