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NPI Code Detail

MEDICARE: KEYSTONE CONTINUUM, LLC

MEDICARE: KEYSTONE CONTINUUM, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1323P00000XPsychiatric Residential Treatment FacilityL000000017337TN

General Provider Information

NPI Number : 1124476643
Entity Type Code : Organization
Provider Name (Legal Business Name) : KEYSTONE CONTINUUM, LLC
Provider Business Mailing Address
First Line : 332 HOSPITAL RD
Second Line :
City : MOUNTAIN CITY
State : TN
Zip : 37683-4309
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 332 HOSPITAL RD
Second Line :
City : MOUNTAIN CITY
State : TN
Zip : 37683-4309
Country : US
Telephone Number : 423-727-9898
Fax Number :
Authorized Official
Title or Position : CEO
Name : ERIC DUNKERLY
Credential :
Telephone Number : 423-727-9898
Provider Enumeration Date : 05/25/2016
Last Update Date : 05/25/2016

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