OrganizationActive
Innovage Pennsylvania Life, LLC
NPI 1023612264 · PACE Provider Organization · Philadelphia, PA
Provider details
- NPI number
- 1023612264
- Entity type
- Organization
- Primary specialty
- PACE Provider OrganizationAgencies
- Parent organization
- Innovage Pennsylvania Life, LLC
- Authorized official
- Lezlie Corbin, Credentialing Coordinator
Mailing address
8950 E Lowry Blvd
Denver, CO 80230-7030
Registry dates
- Enumerated
- 2020-11-29
- Last updated
- 2020-11-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.