Provider Demographics
NPI:1669838900
Name:CROZER-KEYSTONE HEALTH SYSTEM
Entity Type:Organization
Organization Name:CROZER-KEYSTONE HEALTH SYSTEM
Other - Org Name:CROZER-KEYSTONE HEALTHY START
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINSITRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:610-497-7344
Mailing Address - Street 1:2600 W 9TH ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-2040
Mailing Address - Country:US
Mailing Address - Phone:610-497-7344
Mailing Address - Fax:610-497-7472
Practice Address - Street 1:2600 W 9TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-2040
Practice Address - Country:US
Practice Address - Phone:610-497-7460
Practice Address - Fax:610-497-7472
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROZER-KEYSTONE HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-31
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management