Organization
KEYSTONE COMMUNITY RESOURCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ANTHONY DAVITT JR. DO (ACCOUNTS RECEIVABLE COORDINATOR)
(570) 702-8000
Entity
Organization
Contact information
Practice address
1768 MCDONOUGH AVE, SCRANTON, PA 18508-1566
(570) 346-0611
(570) 702-8096
Mailing address
100 ABINGTON EXECUTIVE PARK STE B, CLARKS SUMMIT, PA 18411-2276
(570) 702-8000
(570) 702-8096
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
05
—
100001010
—
PA
Enumeration date
02/11/2020
Last updated
02/11/2020
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