Provider Demographics
NPI:1962467233
Name:KEYSTONE NEURO-REHAB, INC
Entity type:Organization
Organization Name:KEYSTONE NEURO-REHAB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-527-5104
Mailing Address - Street 1:130 BIGELOW ST
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2683
Mailing Address - Country:US
Mailing Address - Phone:724-527-5104
Mailing Address - Fax:724-527-5965
Practice Address - Street 1:130 BIGELOW ST
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-2683
Practice Address - Country:US
Practice Address - Phone:724-527-5104
Practice Address - Fax:724-527-5965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation