NPIMap

Organization Active NPI

Senior Life Greensburg, Inc

  • PACE Provider Organization
  • Greensburg, PA
National Provider Identifier
1003166802
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
SENIOR LIFE GREENSBURG, INC
Practice address
123 Triangle Drive
Greensburg, PA 15601-3510
Phone
(724) 838-8300
NPI assigned
Sep 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Herbert H Hennell
Title
Dir. of Reimbursement
Phone
(412) 963-9150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary
Adult Day Care Clinic/Center 261QA0600X 075064 PA

Addresses

Primary practice location

123 Triangle Drive
Greensburg, PA 15601-3510

Mailing address

209 Sigma Dr
Pittsburgh, PA 15238-2826
Phone (412) 963-9150

Other identifiers 2

IdentifierTypeStateIssuer
102768642-0001MedicaidPA
H2937OtherPAMEDICARE PACE PROVIDER AGREEMENT

Other names 1

  • Senior LIFE Greensburg Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2050854Senior Life Greensburg123 Triangle Drive, Greensburg, PA 15601Certificate of waiverDec 6, 2026

National Provider Directory

National Provider Directory

Locations

123 Triangle Dr
Greensburg, PA 15601
Phone (724) 838-8300

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474848000000",
    "number": "1003166802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SIGMA DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152382826",
            "telephone_number": "412-963-9150",
            "fax_number": "412-963-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 TRIANGLE DRIVE",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156013510",
            "telephone_number": "724-838-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR LIFE GREENSBURG, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2016-09-26",
        "status": "A",
        "authorized_official_last_name": "HENNELL",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIR. OF REIMBURSEMENT",
        "authorized_official_telephone_number": "412-963-9150",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "PA",
            "license": "075064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102768642-0001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PACE PROVIDER AGREEMENT",
            "identifier": "H2937",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior LIFE Greensburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.