Active NPI
Senior Life York, Inc.
Doing business as Senior Life York
- PACE Provider Organization
- York, PA
National Provider Identifier
1356573406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- PACE Provider Organization
- Legal business name
- SENIOR LIFE YORK, INC.
- Doing business as
- Senior Life York
- Practice address
- 1460 Memory Lane Ext
York, PA 17402-9602 - Phone
- (717) 757-5433
- Fax
- (717) 751-0392
- NPI assigned
- Aug 21, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Herbert H Hennell
- Title
- Director of Reimbursement
- Phone
- (412) 963-9150
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| PACE Provider Organization | 251T00000X | Primary | ||
| In Home Supportive Care Agency | 253Z00000X | 19933601 | PA | |
| Adult Day Care Clinic/Center | 261QA0600X | 254600 | PA |
Addresses
Primary practice location
1460 Memory Lane Ext
York, PA 17402-9602
Mailing address
209 Sigma Dr
Pittsburgh, PA 15238-2826
Phone (412) 963-9150
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102381419-0001 | Medicaid | PA | |
| H0819 | Other | PA | MEDICARE AGREEMENT NUMBER |
Other names 1
- Senior Life York
National Provider Directory
National Provider DirectoryLocations
1460 Memory Lane Ext
York, PA 17402
Phone (717) 757-5433
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250812800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1474848000000",
"number": "1356573406",
"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": "1460 MEMORY LANE EXT",
"city": "YORK",
"state": "PA",
"postal_code": "174029602",
"telephone_number": "717-757-5433",
"fax_number": "717-751-0392"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENIOR LIFE YORK, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-08-21",
"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": "DIRECTOR 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": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "PA",
"license": "19933601",
"primary": false
},
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": "PA",
"license": "254600",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102381419-0001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE AGREEMENT NUMBER",
"identifier": "H0819",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Senior Life York",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in York, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.