MEDICARE: YAPA APARTMENT LIVING PROGRAM, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility	198890	PA
2	251S00000X	Community/Behavioral Health Agency	198890	PA

General Provider Information

NPI Number	:	1366770158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YAPA APARTMENT LIVING PROGRAM, INC

Provider Business Mailing Address
First Line	:	1 HIGHLAND DR
Second Line	:
City	:	CHALFONT
State	:	PA
Zip	:	18914-2226
Country	:	US
Telephone Number	:	215-997-9959
Fax Number	:	215-997-1550

Provider Business Practice Location Address
First Line	:	3901 CONSHOHOCKEN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-5430
Country	:	US
Telephone Number	:	215-997-9959
Fax Number	:	215-997-1550

Authorized Official
Title or Position	:	C.F.O.
Name	:	MRS. JERI R PEARSON
Credential	:
Telephone Number	:	215-997-9959

Provider Enumeration Date	:	12/07/2009
Last Update Date	:	06/03/2011

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