Organization
LIVING INDEPENDANTLY FOR ELDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY AUSTIN (CNO)
(215) 746-6893
Entity
Organization
Contact information
Practice address
4508 CHESTNUT ST, PHILA, PA 19139-3608
(215) 746-6893
Mailing address
4508 CHESTNUT ST, PHILA, PA 19139-3608
(215) 746-6893
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
SP010396
PA
Other
Enumeration date
03/24/2010
Last updated
03/24/2010
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