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Organization

KEYSTONE NPS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BETTI COLUCCI (REGIONAL VICE PRESIDENT)
(909) 783-8470
Entity
Organization

Contact information

Practice address
11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5172
(909) 783-8470
(909) 783-7754
Mailing address
11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5172
(909) 783-7754

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
33 66977
CA

Other

Enumeration date
06/07/2011
Last updated
06/07/2011
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