Organization
LIFE ST. MARY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMILY AMERMAN MSW (EXECUTIVE DIRECTOR)
(215) 710-6114
Entity
Organization
Contact information
Practice address
2500 INTERPLEX DRIVE, TREVOSE, PA 19053-6943
(215) 710-6114
Mailing address
1201 LANGHORNE-NEWTOWN RD., LANGHORNE, PA 19047-1201
(215) 710-6114
(215) 710-2298
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H6551
CMS
—
Enumeration date
12/29/2008
Last updated
04/21/2009
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