Organization
KEYSTONE COMMUNITY RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KATIE A PRZYBYLSKI (SUPERVISOR)
(570) 702-8059
Entity
Organization
Contact information
Practice address
498 RINGWOOD AVE, ALPHA, NJ 08865-4821
(570) 702-8000
Mailing address
100 ABINGTON EXECUTIVE PARK STE B, CLARKS SUMMIT, PA 18411-2276
(570) 702-8000
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
—
PA
Enumeration date
10/11/2021
Last updated
10/11/2021
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