Organization
LIFE BEAVER COUNTY
Active
Other names
LIFE Beaver
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN Q DIGIROLAMO (C. F. O.)
(724) 776-1100
Entity
Organization
Contact information
Practice address
131 PLEASANT DR, CENTERPLACE SUITE 1, ALIQUIPPA, PA 15001-1384
(724) 378-5400
(724) 302-2093
Mailing address
1323 FREEDOM RD, CRANBERRY TWP, PA 16066-5001
(724) 776-1100
(724) 776-0811
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
043820
PA
311ZA0620X
Adult Care Home Facility
043820
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019765400001
—
PA
Enumeration date
02/07/2007
Last updated
10/12/2007
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