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General NPI Number Information
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NPI Number | 1578207056
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Entity Type | Organization
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Legal Business Name | KEYSTONE PEER REVIEW ORGANIZATION, INC.
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 777 E PARK DR
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City | HARRISBURG
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State | PA
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Zip | 17111-2754
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Country | US
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Telephone | 717-564-8288
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Fax |
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Provider Business Mailing Address
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Address Line | 777 E PARK DR
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City | HARRISBURG
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State | PA
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Zip | 17111-2754
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF LEGAL OFFICER
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Name | MELISSA LEIGH
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Credential |
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Telephone | 615-933-0293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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