KEYSTONE COMMUNITY RESOURCES INC. NPI 1114510633

NPI Information

NPI: 1114510633
Provider Name: KEYSTONE COMMUNITY RESOURCES INC.
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
559 BRASS CASTLE RD
OXFORD, NJ
ZIP 07863
Phone: (570) 702-8000
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KEYSTONE COMMUNITY RESOURCES INC. is a community based residential treatment facility, intellectual and/or developmental disabilities in Oxford, NJ. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. KEYSTONE COMMUNITY RESOURCES INC. NPI is 1114510633. The provider is registered as an organization entity type.

The provider's business location address is:

559 BRASS CASTLE RD
OXFORD, NJ
ZIP 07863-149
Phone: (570) 702-8000
Fax: (570) 702-8196

The provider's authorized official is David Anthony Davitt .
The authorized official title is Director Of Revenue and has the following contact phone number (570) 702-8000.

The enumeration date for this NPI number is 2/16/2021 and was last updated on 2/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0598747	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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