Organization
KEYSTONE INDEPENDENT LIVING 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
100 ABINGTON EXECUTIVE PARK STE B, CLARKS SUMMIT, PA 18411-2276
(570) 702-8000
(570) 702-8196
Mailing address
100 ABINGTON EXECUTIVE PARK STE B, CLARKS SUMMIT, PA 18411-2276
(570) 702-8000
(570) 702-8196
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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