Organization · Type 2 NPI

Masonic Villages of the Grand Lodge of Pennsylvania

Developmentally Disabled Services Day Training Agency · Elizabethtown, PA

NPI number 1730433343 Active

Practice location

581 Freemason Dr
Elizabethtown, PA 17022-3187

Call (717) 367-1121 Map

Fax (717) 367-5813

Mailing address

1 Masonic Dr
Elizabethtown, PA 17022-2199

Specialties and licenses

Taxonomy	Code	License
Developmentally Disabled Services Day Training Agency Primary	251C00000X	None listed
Adult Day Care Clinic/Center	261QA0600X	261960 (PA)

Developmentally Disabled Services Day Training Agency: These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational function…

3 other providers at this address

NPI record

NPI: 1730433343
Entity type: Organization (Type 2)
Issued: Nov 5, 2012
Last updated: May 1, 2023
Status: Active

Other names

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Masonic Village at Elizabethtown · doing business as
Masonic Village at Elizabethtown · doing business as

Authorized official

Ms. Pamela Formica
Chief Financial Officer
(717) 367-1121

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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 1730433343

Masonic Villages of the Grand Lodge of Pennsylvania's National Provider Identifier is 1730433343, issued on Nov 5, 2012. The primary taxonomy on file is Developmentally Disabled Services Day Training Agency (251C00000X), and the practice location is in Elizabethtown, PA. The record was last updated on May 1, 2023.