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NPI Code Detail

MEDICARE: GOODWILL KEYSTONE AREA

MEDICARE: GOODWILL KEYSTONE AREA
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2261QR0400XRehabilitation Clinic/Center
3347E00000XTransportation Broker
4251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1437608148
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOODWILL KEYSTONE AREA
Provider Business Mailing Address
First Line : 1150 GOODWILL DR
Second Line :
City : HARRISBURG
State : PA
Zip : 17101-2400
Country : US
Telephone Number : 717-232-1831
Fax Number :
Provider Business Practice Location Address
First Line : 1150 GOODWILL DR
Second Line :
City : HARRISBURG
State : PA
Zip : 17101-2400
Country : US
Telephone Number : 717-232-1831
Fax Number :
Authorized Official
Title or Position : CEO
Name : MS. RONALD KRATOFIL
Credential :
Telephone Number : 717-232-1831
Provider Enumeration Date : 09/23/2016
Last Update Date : 09/23/2016

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Directions to “GOODWILL KEYSTONE AREA ” Practice Location

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