NPIMap

Organization Active NPI

Keystone Community Resources, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Gouldsboro, PA
National Provider Identifier
1972084945
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
CER-00128996 Issued in PA
Legal business name
KEYSTONE COMMUNITY RESOURCES, INC.
Practice address
178 Main St
Gouldsboro, PA 18424-8834
Phone
(570) 842-0950
NPI assigned
Aug 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Authorized official

Name
Mr. David Anthony Davitt Jr., DO
Title
Accounts Receivable Coordinator
Phone
(570) 702-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X CER-00128996 PA Primary

Addresses

Primary practice location

178 Main St
Gouldsboro, PA 18424-8834

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Keystone Community Resources Inc47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

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

View all 46

Locations

178 Main St
Gouldsboro, PA 18424
Phone (570) 842-0950

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1972084945",
    "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": "178 MAIN ST",
            "city": "GOULDSBORO",
            "state": "PA",
            "postal_code": "184248834",
            "telephone_number": "570-842-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE COMMUNITY RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-27",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "DAVITT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE COORDINATOR",
        "authorized_official_telephone_number": "570-702-8000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "PA",
            "license": "CER-00128996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gouldsboro, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.