Provider Demographics
NPI:1891369955
Name:KEYSTONE HOME HEALTH D3 LLC
Entity type:Organization
Organization Name:KEYSTONE HOME HEALTH D3 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARBACIK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:727-669-2777
Mailing Address - Street 1:9600 KOGER BLVD N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2487
Mailing Address - Country:US
Mailing Address - Phone:727-669-2777
Mailing Address - Fax:
Practice Address - Street 1:9600 KOGER BLVD
Practice Address - Street 2:INACTIVE
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702
Practice Address - Country:US
Practice Address - Phone:727-669-2777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health