Healthcare Provider Details

I. General information

NPI: 1588609044
Provider Name (Legal Business Name): KEYSTONE REHABILITATION SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 STRUTHERS LIBERTY RD
CAMPBELL OH
44405-1973
US

IV. Provider business mailing address

PO BOX 1245
INDIANA PA
15701-5245
US

V. Phone/Fax

Practice location:
  • Phone: 330-750-0800
  • Fax: 330-750-0693
Mailing address:
  • Phone: 724-465-3496
  • Fax: 215-413-4682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CYNTHIA L. GOLDBERG
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 610-644-7824