NPIMap

Organization Active NPI

Seniorlife Washington, Inc.

Doing business as SeniorLife Washington

  • PACE Provider Organization
  • Washington, PA
National Provider Identifier
1497998876
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
SENIORLIFE WASHINGTON, INC.
Doing business as
SeniorLife Washington
Practice address
2114 North Franklin Drive
Washington, PA 15301
Phone
(724) 222-5433
Fax
(814) 248-7902
NPI assigned
Apr 14, 2009
Last updated
Sep 26, 2016By the provider in NPPES
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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 084480 PA
Adult Day Care Clinic/Center 261QA0600X 084490 PA
In Home Supportive Care Agency 253Z00000X 19943601 PA
In Home Supportive Care Agency 253Z00000X 19953601 PA
PACE Provider Organization 251T00000X NU Primary

Addresses

Primary practice location

2114 North Franklin Drive
Washington, PA 15301

Mailing address

209 Sigma Dr
Pittsburgh, PA 15238-2826
Phone (412) 996-3915

Other identifiers 3

IdentifierTypeStateIssuer
102324931-0002MedicaidPA
H2992OtherPAMEDICARE PACE PROGRAM AGREEMENT
102324931-0001MedicaidPA

Other names 1

  • SeniorLife Washington Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Senior Life Washington2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2114 N Franklin Dr
Washington, PA 15301
Phone (724) 222-5433

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474848000000",
    "number": "1497998876",
    "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": "412-996-3915",
            "fax_number": "412-963-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 NORTH FRANKLIN DRIVE",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "15301",
            "telephone_number": "724-222-5433",
            "fax_number": "814-248-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIORLIFE WASHINGTON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-14",
        "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": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "PA",
            "license": "084480",
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "PA",
            "license": "084490",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": "19943601",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": "19953601",
            "primary": false
        },
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102324931-0002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PACE PROGRAM AGREEMENT",
            "identifier": "H2992",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102324931-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SeniorLife Washington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, 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.