Provider Demographics
NPI:1437608148
Name:GOODWILL KEYSTONE AREA
Entity type:Organization
Organization Name:GOODWILL KEYSTONE AREA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:KRATOFIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-232-1831
Mailing Address - Street 1:1150 GOODWILL DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17101-2400
Mailing Address - Country:US
Mailing Address - Phone:717-232-1831
Mailing Address - Fax:
Practice Address - Street 1:1150 GOODWILL DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2400
Practice Address - Country:US
Practice Address - Phone:717-232-1831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No347E00000XTransportation ServicesTransportation Broker