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Organization

KEYSTONE PASSIONATE CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEANDRE NORDT (CEO)
(717) 683-9244
Entity
Organization

Contact information

Practice address
2040 LINGLESTOWN RD STE 302, HARRISBURG, PA 17110-9568
(717) 265-6826
Mailing address
4709 BUCK RUN LN, HARRISBURG, PA 17110-3265
(717) 683-9244

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1034920650001
PA
Enumeration date
03/24/2020
Last updated
03/24/2020
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