INNOVAGE PENNSYLVANIA LIFE, LLC (NPI# 1588279657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588279657 |
| Entity Type | Organization |
| Organization Name | INNOVAGE PENNSYLVANIA LIFE, LLC |
| Practice Address |
4401 Megargee St Philadelphia PA 19136-2160 |
| Mailing Address |
8950 E Lowry Blvd Denver CO 80230-7030 |
| Practice Telephone | 8442921028 |
| Mailing Telephone | 8442921028 |
| Mailing Fax Number | 3038694664 |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |
| Authorized Official Name | VANESSA DEBORAH WALTON (CHIEF LEGAL OFFICER) |
| Authorized Official Telephone | 3032421352 |
| Is Organization Subpart | Y |
| Parent Organization Name | TOTAL COMMUNITY OPTIONS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | Agencies |
| Other Name | Type Code |
|---|---|
| InnovAge Pennsylvania LIFE-Pennypack | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104954569 | Innovage Pennsylvania Life, LLC | PACE Provider Organization | 6950 Germantown Ave, Philadelphia, PA 19119 | 2007-02-28 |
| Street Address |
4401 MEGARGEE ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19136-2160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801361274 | Mary Ann Theresa Mcintyre | Social Worker | 3501 Solly Avenue, Philadelphia, PA 19136 | 2018-10-11 |
| 1396227732 | Chiropractor Dynamic PC | Chiropractor | 7337 Frankford Ave, Philadelphia, PA 19136 | 2018-09-01 |
| 1932689478 | Jenna Nicole Harrison | Physical Therapist | 7343-7345 Frankford Avenue, Philadelphia, PA 19136 | 2018-08-15 |
| 1063932069 | Rachel Alexa Allen | Counselor | 3254 Teesdale Street, Philadelphia, PA 19136 | 2017-06-21 |
| 1962944371 | Erin Hartey | Counselor | 4323 Vista St, Phila, PA 19136 | 2016-11-16 |
| 1932657715 | Janice Lisette Frisby | Counselor | 8454 Jackson Street, Philadelphia, PA 19136 | 2016-09-21 |
| 1326428541 | General Healthcare Agency | Community/Behavioral Health | 4616 Ashville St, Philadelphia, PA 19136 | 2015-06-03 |
| 1215314653 | Sincere Home Health Care Service | In Home Supportive Care | 4510 Aberdale Road, Philadelphia, PA 19136 | 2015-05-06 |
| 1497159420 | Creative Steps Incorporated | Clinic/Center | 8045 Frankford Avenue, Philadelphia, PA 19136 | 2014-10-20 |
| 1316379779 | Epic Physicians L.L.C. | Clinic/Center | 8021 Frankford Ave, Philadelphia, PA 19136 | 2013-08-07 |
| Find all providers in zip 19136 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265919377 | Cozy Caregivers Homecare Agency | PACE Provider Organization | 5031 Baltimore Ave Apt 1, Philadelphia, PA 19143-1670 | 2018-07-20 |
| 1033618996 | Acts of Faith Corp | PACE Provider Organization | 2453 S 61st St, Philadelphia, PA 19142-3215 | 2018-02-06 |
| 1538210380 | Trustees of The University of Pennsylvania | PACE Provider Organization | 4101 Woodland Ave, Philadelphia, PA 19104-4510 | 2007-01-16 |
| 1710347661 | Trinity Health Life Pennsylvania, Inc. | PACE Provider Organization | 4508 Chestnut St, Philadelphia, PA 19139-3608 | 2016-03-03 |
| 1174881627 | St. Agnes Continuing Care Center | PACE Provider Organization | 1930 S Broad St, Philadelphia, PA 19145-2328 | 2012-05-02 |
| 1104954569 | Innovage Pennsylvania Life, LLC | PACE Provider Organization | 6950 Germantown Ave, Philadelphia, PA 19119 | 2007-02-28 |
| 1881738565 | Saint Agnes Continuing Care Center | PACE Provider Organization | 1900 S Broad St, Philadelphia, PA 19145-2304 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102731 | Bitner Counseling, LLC | PACE Provider Organization | 1 Northgate Sq Ste 215, Greensburg, PA 15601-1373 | 2020-07-27 |
| 1477949139 | Care At Home of Delaware Valley | PACE Provider Organization | 102 Center Mill Rd, Chadds Ford, PA 19317-9212 | 2015-04-09 |
| 1659776193 | Viecare Armstrong, LLC | PACE Provider Organization | 115 Nolte Drive Ext, Kittanning, PA 16201 | 2014-10-27 |
| 1851647796 | Albright Care Services | PACE Provider Organization | 113 S 9th St, Lebanon, PA 17042-5108 | 2012-07-30 |
| 1073802013 | Support for Independent Living, LLC | PACE Provider Organization | 2320 Haverford Rd, Suite 220, Ardmore, PA 19003-2913 | 2011-03-30 |
| 1023289147 | Phi Life | PACE Provider Organization | 1217 Slate Hill Rd, Camp Hill, PA 17011-8012 | 2008-03-17 |
| 1740467570 | Spiritrust Lutheran Life | PACE Provider Organization | 1920 Good Hope Road, Enola, PA 17025 | 2008-01-23 |
| 1710182647 | Viecare Butler, LLC | PACE Provider Organization | 229 W Diamond St, Butler, PA 16001-5784 | 2007-06-20 |
| 1891822284 | Albright Life | PACE Provider Organization | 417 W Frederick St, Lancaster, PA 17603-2804 | 2007-02-27 |
| 1902932007 | Albright Care Services | PACE Provider Organization | 400 Lycoming St, Williamsport, PA 17701-4974 | 2007-02-26 |
| Find all providers with the same taxonomy | ||||
| City | PHILADELPHIA |
| Zip Code | 19136 |
Please comment or provide details below to improve the information on INNOVAGE PENNSYLVANIA LIFE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.