Organization
KEYSTONE AUTISM SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES HOOKER (CEO)
(717) 232-7509
Entity
Organization
Contact information
Practice address
124 PINE ST, HARRISBURG, PA 17101-1208
(717) 232-7509
(717) 232-6687
Mailing address
124 PINE ST, HARRISBURG, PA 17101-1208
(717) 232-7509
(717) 232-6687
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
331960
PA
251T00000X
PACE Provider Organization
2953440
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020600830001
—
PA
05
—
1020600830003
—
PA
05
—
1020600830004
—
PA
05
—
1020600830006
—
PA
Enumeration date
10/22/2007
Last updated
11/04/2015
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