| Organization Name: | KEYSTONE MEDICAL, PLLC |
| NPI Number: | 1477975647 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REBECCA PRADHAN-NARA (SOLE MEMBER) |
| Mailing Address: | 77 Calle Portal Suite B260a Sierra Vista |
| State: | AZ US |
| Postal Code: | 856352967 |
| Phone Number: | 5202264338 |
| Fax Number: | 5205159786 |
| NPI Enumeration Date: | 01/07/2014 |
| NPI Last Update Date: | 01/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 310400000X |
| License Number: | 32180 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |