Healthcare Provider Details

I. General information

NPI: 1184823502
Provider Name (Legal Business Name): KEYSTONE CONTINUUM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 HOSPITAL RD
MOUNTAIN CITY TN
37683-4309
US

IV. Provider business mailing address

332 HOSPITAL RD
MOUNTAIN CITY TN
37683-4309
US

V. Phone/Fax

Practice location:
  • Phone: 423-727-9898
  • Fax:
Mailing address:
  • Phone: 423-727-9898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LINDA FRANCISCO
Title or Position: BOM
Credential:
Phone: 423-727-9898