Organization
KEYSTONE COMMUNITY LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAY FANTUZZI (PRESIDENT)
(908) 757-1080
Entity
Organization
Contact information
Practice address
62 BALMORAL AVE, MATAWAN, NJ 07747-3503
(908) 757-1080
(908) 755-6810
Mailing address
154 FRONT ST, SOUTH PLAINFIELD, NJ 07080-3402
(908) 757-1080
(908) 755-6810
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/08/2015
Last updated
01/10/2018
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