Provider Demographics
NPI:1609011378
Name:CROZER-KEYSTONE COMMUNITY FOUNDATION
Entity Type:Organization
Organization Name:CROZER-KEYSTONE COMMUNITY FOUNDATION
Other - Org Name:CROZER-KEYSTONE NURSE-FAMILY PARTNERSHIP
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:610-497-7344
Mailing Address - Street 1:200 E STATE ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3434
Mailing Address - Country:US
Mailing Address - Phone:610-744-1010
Mailing Address - Fax:
Practice Address - Street 1:2602 W 9TH ST
Practice Address - Street 2:COMMUNITY HOSPITAL MOB 2ND FLOOR
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-2040
Practice Address - Country:US
Practice Address - Phone:610-497-7344
Practice Address - Fax:610-497-7472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty