MEDICARE: LIFESPAN, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251V00000X	Voluntary or Charitable Agency
3	332U00000X	Home Delivered Meals

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962924381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESPAN, INC.

Provider Business Mailing Address
First Line	:	314 E 8TH AVE
Second Line	:
City	:	HOMESTEAD
State	:	PA
Zip	:	15120-1518
Country	:	US
Telephone Number	:	412-464-1300
Fax Number	:	412-461-7118

Provider Business Practice Location Address
First Line	:	314 E 8TH AVE
Second Line	:
City	:	HOMESTEAD
State	:	PA
Zip	:	15120-1518
Country	:	US
Telephone Number	:	412-464-1300
Fax Number	:	412-461-7118

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	VIRGINIA JUROFCIK
Credential	:
Telephone Number	:	412-464-1300

Provider Enumeration Date	:	07/07/2017
Last Update Date	:	07/21/2022

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Directions to “LIFESPAN, INC. ” Practice Location

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