Organization Name: | LIFE ST. MARY |
NPI Number: | 1003052820 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EMILY AMERMAN (EXECUTIVE DIRECTOR) |
Mailing Address: | 2500 Interplex Drive Trevose |
State: | PA US |
Postal Code: | 190536943 |
Phone Number: | 2157106114 |
Fax Number: | |
NPI Enumeration Date: | 12/29/2008 |
NPI Last Update Date: | 04/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |