Keystone Residential Care, LLC

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

KEYSTONE RESIDENTIAL CARE, LLC

Practice address

6062 S Hidden PL
Taylorsville, UT 84123-7676

Phone

(801) 949-8509

NPI assigned

Dec 2, 2020

Organization subpart

No

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

Authorized official

Name

Moana Olivia Hansen

Title

Executive Director

Phone

(801) 949-8509

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606867200000",
    "number": "1770188195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6062 S HIDDEN PL",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841237676",
            "telephone_number": "801-949-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6062 S HIDDEN PL",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841237676",
            "telephone_number": "801-949-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "MOANA",
        "authorized_official_middle_name": "OLIVIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-949-8509"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Taylorsville, UT by specialty
• Foster Care Agency in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.