Provider Demographics
NPI:1396785259
Name:KEYSTONE NURSING HOME, INC
Entity type:Organization
Organization Name:KEYSTONE NURSING HOME, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:44 KEYSTONE DR
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1904
Practice Address - Country:US
Practice Address - Phone:978-537-9327
Practice Address - Fax:978-534-1914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0092314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
6080571OtherCIGNA(HEALTHSOURCE OF MA)
714378OtherAETNA-HMO
MA0940259Medicaid
71-00188OtherUNITED-EVERCARE
6080571OtherCIGNA(HEALTHSOURCE OF MA)
71-00188OtherUNITED-EVERCARE
714378OtherAETNA-HMO
=========OtherSENIOR WHOLE HEALTH