OrganizationActive
Living Independently for Elders
NPI 1598088494 · Exclusive Provider Organization · Phila, PA
Provider details
- NPI number
- 1598088494
- Entity type
- Organization
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Gwen Lech, Nurse Practitioner(215) 386-1094
Specialties & taxonomies
Managed Care Organizations
Practice location
4508 Chestnut St
Phila, PA 19139-3608
Phone: (215) 573-7200
Approximate (ZIP-level) locationGet directions
Mailing address
4508 Chestnut St
Phila, PA 19139-3608
Registry dates
- Enumerated
- 2010-03-05
- Last updated
- 2010-03-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.