Organization
KEYSTONE INDEPENDENT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT FLEESE (PRESIDENT/OWNER)
(570) 702-8104
Entity
Organization
Contact information
Practice address
202 BOULEVARD AVE, PECKVILLE, PA 18452-1002
(570) 307-4067
Mailing address
100 ABINGTON EXECUTIVE PARK, SUITE B, CLARKS SUMMIT, PA 18411-2260
(570) 702-8000
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
226650
PA
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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