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General NPI Number Information
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NPI Number | 1164030276
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Entity Type | Organization
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Legal Business Name | KEYSTONE HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 787 PINE VALLEY DR STE C
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City | PITTSBURGH
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State | PA
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Zip | 15239-2832
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Country | US
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Telephone | 724-571-7685
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Fax | 724-558-9555
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Provider Business Mailing Address
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Address Line | 614 E MAIN ST STE C
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City | RIVERTON
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State | WY
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Zip | 82501-4460
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Country | US
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Telephone | 307-856-2600
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Fax | 307-856-2400
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Authorized Official
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Title or Position | LICENSING / COMPLIANCE
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Name | RENEE LAWSON
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Credential | RN
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Telephone | 307-856-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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