Provider Demographics
NPI:1902489966
Name:KEYSTONE HOME HEALTH D6 LLC
Entity Type:Organization
Organization Name:KEYSTONE HOME HEALTH D6 LLC
Other - Org Name:KEYSTONE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
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:813-372-5777
Mailing Address - Street 1:10002 PRINCESS PALM AVE STE 216
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-1386
Mailing Address - Country:US
Mailing Address - Phone:813-372-5777
Mailing Address - Fax:813-372-5776
Practice Address - Street 1:10002 PRINCESS PALM AVE STE 216
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-1386
Practice Address - Country:US
Practice Address - Phone:813-372-5777
Practice Address - Fax:813-372-5776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health