Innovage Pennsylvania Life, Llc

LBN: Innovage Pennsylvania Life, Llc
Innovage Pennsylvania Life, Llc is an health care organization with primary practice located at 5364 Jackson St , Philadelphia PA 19124-1565. The organization recently has only one registered license in Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization, which is considered as the primary health care specialty. Innovage Pennsylvania Life, Llc can be contacted via phone (215) 288-3303, or through Corbin, Lezlie via phone (215) 734-9587.

Contact Information

Primary practice address
5364 Jackson St Philadelphia PA 19124-1565
Phone: (215) 288-3303
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Corbin, Lezlie
Phone: (215) 734-9587

Health care specialties

SpecialtyCodeLicense #State
Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization 251T00000X

Profile Details

NPI number 1467056655
LBN Legal business name Innovage Pennsylvania Life, Llc
DBA Doing business as
Authorized official Corbin, Lezlie
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 28th, 2020
Last updated Nov 28th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467056655 NPPES
Pennsylvania MEDICAID 101734256-0004

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