Provider Demographics
NPI:1548429616
Name:KEYSTONE REHABILITATION SYSTEMS INC
Entity Type:Organization
Organization Name:KEYSTONE REHABILITATION SYSTEMS INC
Other - Org Name:KEYSTONE REHABILITATION SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:FLECK
Authorized Official - Last Name:POOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-467-8705
Mailing Address - Street 1:665 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3941
Mailing Address - Country:US
Mailing Address - Phone:724-465-3496
Mailing Address - Fax:724-465-3726
Practice Address - Street 1:125 SIMPSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417-9624
Practice Address - Country:US
Practice Address - Phone:724-785-2106
Practice Address - Fax:724-785-2107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396534Medicare Oscar/Certification