Healthcare Provider Details

I. General information

NPI: 1518986777
Provider Name (Legal Business Name): KEYSTONE RICHLAND CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 LUCAS ROAD
MANSFIELD OH
44903-8682
US

IV. Provider business mailing address

1451 LUCAS ROAD
MANSFIELD OH
44903-8682
US

V. Phone/Fax

Practice location:
  • Phone: 419-589-5511
  • Fax: 419-589-7381
Mailing address:
  • Phone: 419-589-5511
  • Fax: 419-589-7381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number200512503156
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: KAREN SPIKES
Title or Position: CEO
Credential:
Phone: 419-589-5511