Organization Active NPI

Keystone Independent Living Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Clarks Summit, PA
National Provider Identifier
1861033151
Registry record updated Aug 18, 2026
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 INDEPENDENT LIVING INC.
Practice address
100 Abington Executive Park Ste B
Clarks Summit, PA 18411-2276
Phone
(570) 702-8000
Fax
(570) 702-8196
NPI assigned
Oct 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Authorized official

Name
Adrienne York
Title
Director Revenue Cycle
Phone
(570) 702-8000

Specialties & licenses 1

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

Addresses

Primary practice location

100 Abington Executive Park Ste B
Clarks Summit, PA 18411-2276

Mailing address

100 Abington Executive Park Ste B
Clarks Summit, PA 18411-2276
Phone (570) 702-8000

Other identifiers 1

IdentifierTypeStateIssuer
100001029MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Keystone Independent Living Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787011200000",
    "number": "1861033151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ABINGTON EXECUTIVE PARK STE B",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184112276",
            "telephone_number": "570-702-8000",
            "fax_number": "570-702-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ABINGTON EXECUTIVE PARK STE B",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184112276",
            "telephone_number": "570-702-8000",
            "fax_number": "570-702-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE INDEPENDENT LIVING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A",
        "authorized_official_last_name": "YORK",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "570-702-8000"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001029",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.