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NPI 1013519735

OrganizationActive

Innovage Pennsylvania Life, LLC

NPI 1013519735 · PACE Provider Organization · Philadelphia, PA

Provider details

NPI number: 1013519735
Entity type: Organization
Primary specialty: PACE Provider OrganizationAgencies
Parent organization: Innovage Pennsylvania Life - Allegheny
Authorized official: Gayle Washington, Credentialing

Practice location

1940 W Allegheny Ave

Philadelphia, PA 19132-1614

Phone: (267) 335-1500

More PA providers

Mailing address

8950 E Lowry Blvd

Denver, CO 80230-7030

Registry dates

Enumerated: 2020-11-09
Last updated: 2020-11-09

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Innovage Pennsylvania Life, LLC — NPI 1013519735, Philadelphia, PA | NPI Central