Organization
SENIORLIFE WASHINGTON, INC.
Active
Other names
SeniorLife Washington
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT H HENNELL (DIRECTOR OF REIMBURSEMENT)
(412) 963-9150
Entity
Organization
Contact information
Practice address
2114 NORTH FRANKLIN DRIVE, WASHINGTON, PA 15301
(724) 222-5433
(814) 248-7902
Mailing address
209 SIGMA DR, PITTSBURGH, PA 15238-2826
(412) 996-3915
(412) 963-6676
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
253Z00000X
In Home Supportive Care Agency
19943601
PA
253Z00000X
In Home Supportive Care Agency
19953601
PA
261QA0600X
Adult Day Care Clinic/Center
084480
PA
261QA0600X
Adult Day Care Clinic/Center
084490
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102324931-0001
—
PA
05
—
102324931-0002
—
PA
01
—
H2992
MEDICARE PACE PROGRAM AGREEMENT
PA
Enumeration date
04/14/2009
Last updated
09/26/2016
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