Provider Demographics
NPI:1326498460
Name:AMERICAN KEYSTONE HOME CARE
Entity Type:Organization
Organization Name:AMERICAN KEYSTONE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-507-0160
Mailing Address - Street 1:4422 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:PA
Mailing Address - Zip Code:19560-1632
Mailing Address - Country:US
Mailing Address - Phone:610-507-0160
Mailing Address - Fax:
Practice Address - Street 1:4422 12TH AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:PA
Practice Address - Zip Code:19560-1632
Practice Address - Country:US
Practice Address - Phone:610-507-0160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30593601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care