Healthcare Provider Details

I. General information

NPI: 1740245471
Provider Name (Legal Business Name): KEYSTONE NEURO-REHAB, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 BIGELOW ST
JEANNETTE PA
15644-2683
US

IV. Provider business mailing address

130 BIGELOW ST
JEANNETTE PA
15644-2683
US

V. Phone/Fax

Practice location:
  • Phone: 724-527-5104
  • Fax: 724-527-5965
Mailing address:
  • Phone: 724-527-5104
  • Fax: 724-527-5965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. CHERYL RAFFERTY
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 724-527-5104