Organization
INNOVAGE PENNSYLVANIA LIFE, LLC
Active
Parent organization
TOTAL COMMUNITY OPTIONS INC
Other names
InnovAge Pennsylvania LIFE-Pennypack
Organization subpart
Yes
Provider details
NPI number
Legal business name
TOTAL COMMUNITY OPTIONS INC
Authorized official
VANESSA DEBORAH WALTON (CHIEF LEGAL OFFICER)
(303) 242-1352
Entity
Organization
Contact information
Practice address
4401 MEGARGEE ST, PHILADELPHIA, PA 19136-2160
(844) 292-1028
Mailing address
8950 E LOWRY BLVD, DENVER, CO 80230-7030
(844) 292-1028
(303) 869-4664
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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