NPI 1467056655

Innovage Pennsylvania Life, LLC

Organisation PACE Provider Organization Philadelphia, PA

Practice location

Address: 5364 Jackson St, Philadelphia, PA 19124-1565
Phone: (215) 288-3303
Mailing address: 8950 E Lowry Blvd, Denver, CO 80230-7030

Authorised official

Name: Lezlie Corbin
Title: Credentialing Coordinator
Phone: (215) 734-9587

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Pennsylvania →

Registry record

NPI: 1467056655
Entity type: Organization
NPI issued: 28 Nov 2020
Record last updated: 28 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.