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Innovage Pennsylvania Life, LLC — NPI 1467056655, Philadelphia, PA | NPI Central

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NPI 1467056655

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Innovage Pennsylvania Life, LLC

NPI 1467056655 · PACE Provider Organization · Philadelphia, PA

Provider details

NPI number: 1467056655
Entity type: Organization
Primary specialty: PACE Provider OrganizationAgencies
Parent organization: Innovage Pennsylvania Life, LLC
Organization subpart: Yes
Authorized official: Lezlie Corbin, Credentialing Coordinator(215) 734-9587

Specialties & taxonomies

PACE Provider OrganizationPrimary251T00000X
Agencies

Practice location

5364 Jackson St

Philadelphia, PA 19124-1565

Phone: (215) 288-3303

Approximate (ZIP-level) locationGet directions

More PA providers

Mailing address

8950 E Lowry Blvd

Denver, CO 80230-7030

Other names (DBA / former)

Doing business as: Innovage Pennsylvania Life - St. Bart'S

Registry dates

Enumerated: 2020-11-28
Last updated: 2020-11-28
Certified: 2020-11-28

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