NPIMap

Organization Active NPI

Seniorlife Lehigh Valley, Inc.

  • PACE Provider Organization
  • Bethlehem, PA
National Provider Identifier
1356789358
Registry record updated Jan 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
SENIORLIFE LEHIGH VALLEY, INC.
Practice address
3365 High Point Blvd
Bethlehem, PA 18017-7806
Phone
(610) 954-5433
Fax
(610) 691-1075
NPI assigned
Jun 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2017

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X PA Primary
Adult Day Care Clinic/Center 261QA0600X 335230 PA
Adult Day Care Clinic/Center 261QA0600X 325574 PA

Addresses

Primary practice location

3365 High Point Blvd
Bethlehem, PA 18017-7806

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
5978OtherMEDICARE PROVIDER AGREEMENT
102862789-0003MedicaidPA
102862789-0001MedicaidPA

Other names 1

  • SeniorLIFE Lehigh Valley Doing business as

National Provider Directory

National Provider Directory

Locations

3365 High Point Blvd
Bethlehem, PA 18017
Phone 6109545433 ext. 31547

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1356789358",
    "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": "3365 HIGH POINT BLVD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177806",
            "telephone_number": "610-954-5433",
            "fax_number": "610-691-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIORLIFE LEHIGH VALLEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2017-01-27",
        "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": "PA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "PA",
            "license": "335230",
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "PA",
            "license": "325574",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER AGREEMENT",
            "identifier": "5978",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102862789-0003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102862789-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SeniorLIFE Lehigh Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.