Organization
PORTRAITS OF LIFE ADULT DAY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONSTANCE LOUISE EISENHAUER (CFO/OWNER)
(717) 360-7074
Entity
Organization
Contact information
Practice address
419 MARKET STREET, LYKENS, PA 17048-1316
(717) 453-9355
(717) 453-0846
Mailing address
419 MARKET STREET, LYKENS, PA 17048
(717) 453-9355
(717) 453-0846
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
232830
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01732517
—
PA
Enumeration date
11/29/2006
Last updated
11/02/2021
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