Organization · Type 2 NPI

Innovage Pennsylvania Life, LLC

PACE Provider Organization · Philadelphia, PA

NPI number 1467056655 Active

Practice location

5364 Jackson St
Philadelphia, PA 19124-1565

Call (215) 288-3303 Map

Mailing address

8950 E Lowry Blvd
Denver, CO 80230-7030

Specialties and licenses

Taxonomy	Code	License
PACE Provider Organization Primary	251T00000X	None listed

PACE Provider Organization: A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE ser…

2 other providers at this address

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NPI record

NPI: 1467056655
Entity type: Organization (Type 2)
Issued: Nov 28, 2020
Last updated: Nov 28, 2020
Status: Active
Subpart: Yes of Innovage Pennsylvania Life, LLC

Other names

Innovage Pennsylvania Life - St. Bart's · doing business as

Authorized official

Lezlie Corbin
Credentialing Coordinator
(215) 734-9587

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1467056655

Innovage Pennsylvania Life, LLC's National Provider Identifier is 1467056655, issued on Nov 28, 2020. The primary taxonomy on file is PACE Provider Organization (251T00000X), and the practice location is in Philadelphia, PA. The record was last updated on Nov 28, 2020.