Organization
KEYSTONE COMMUNITY RESOURCES INC.
Active
Parent organization
BEACON SERVICES HOLDINGS INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEACON SERVICES HOLDINGS INC.
Authorized official
MR. DAVID ANTHONY DAVITT JR. DO (DIRECTOR OF REVENUE)
(570) 702-8000
Entity
Organization
Contact information
Practice address
900 GIBBONS ST, SCRANTON, PA 18505-3614
(570) 207-1908
Mailing address
100 ABINGTON EXECUTIVE PARK STE B, CLARKS SUMMIT, PA 18411-2276
(570) 702-8000
(570) 702-8196
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0598747
—
NJ
Enumeration date
05/13/2021
Last updated
05/13/2021
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