=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023266517
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KEYSTONE HOME HEALTHCARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2008
-----------------------------------------------------
Last Update Date | 09/09/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 140 E RICHARDSON AVE SECOND FLOOR FRONT
-----------------------------------------------------
City | LANGHORNE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19047-2857
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-757-7776
-----------------------------------------------------
Fax | 215-757-7773
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 140 EAST RICHARDSON AVE SECOND FLOOR FRONT
-----------------------------------------------------
City | LANGHORNE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-757-7776
-----------------------------------------------------
Fax | 215-757-7773
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | EMILY AROWOSAYE
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 215-757-7776
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------