Organization Active NPI

Senior Life York, Inc.

Doing business as Senior Life York

  • PACE Provider Organization
  • York, PA
National Provider Identifier
1356573406
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 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

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
Director of Reimbursement
Phone
(412) 963-9150

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
102381419-0001MedicaidPA
H0819OtherPAMEDICARE AGREEMENT NUMBER

Other names 1

  • Senior Life York Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.