Healthcare Provider Details

I. General information

NPI: 1285755728
Provider Name (Legal Business Name): KEYSTONE SERVICE SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 BENNER PIKE
STATE COLLEGE PA
16801-7395
US

IV. Provider business mailing address

124 PINE ST
HARRISBURG PA
17101-1208
US

V. Phone/Fax

Practice location:
  • Phone: 717-232-7509
  • Fax: 717-232-6687
Mailing address:
  • Phone: 717-232-7509
  • Fax: 717-232-6687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier100001038 0365
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MR. CHARLES OOKER
Title or Position: CEO
Credential:
Phone: 717-232-7509