Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Other names
LIFE (Living Independently For Elders)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE D. PENDLETON MSW (EXECUTIVE DIRECTOR)
(215) 898-4417
Entity
Organization
Contact information
Practice address
4101 WOODLAND AVE, PHILADELPHIA, PA 19104-4510
(215) 573-7200
(215) 573-4442
Mailing address
4101 WOODLAND AVE, PHILADELPHIA, PA 19104-4510
(215) 573-7200
(215) 573-4442
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
PA
Other
Enumeration date
01/16/2007
Last updated
08/22/2020
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