Organization
SENIORLIFE LEHIGH VALLEY, INC.
Active
Other names
SeniorLIFE Lehigh Valley
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
3365 HIGH POINT BLVD, BETHLEHEM, PA 18017-7806
(610) 954-5433
(610) 691-1075
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
—
PA
261QA0600X
Adult Day Care Clinic/Center
325574
PA
261QA0600X
Adult Day Care Clinic/Center
335230
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102862789-0001
—
PA
05
—
102862789-0003
—
PA
01
—
5978
MEDICARE PROVIDER AGREEMENT
—
Enumeration date
06/12/2013
Last updated
01/27/2017
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