Organization
SENIOR LIFE GREENSBURG, INC
Active
Other names
Senior LIFE Greensburg
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT H HENNELL (DIR. OF REIMBURSEMENT)
(412) 963-9150
Entity
Organization
Contact information
Practice address
123 TRIANGLE DRIVE, GREENSBURG, PA 15601-3510
(724) 838-8300
Mailing address
209 SIGMA DR, PITTSBURGH, PA 15238-2826
(412) 963-9150
(412) 963-6676
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
075064
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102768642-0001
—
PA
01
—
H2937
MEDICARE PACE PROVIDER AGREEMENT
PA
Enumeration date
09/19/2012
Last updated
09/26/2016
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