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General NPI Number Information
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NPI Number | 1457419509
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Entity Type | Organization
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Legal Business Name | HUMANGOOD PENNSYLVANIA
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 2002 JOSHUA RD
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City | LAFAYETTE HILL
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State | PA
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Zip | 19444-2430
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Country | US
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Telephone | 610-828-4848
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Fax | 610-828-4864
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Provider Business Mailing Address
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Address Line | 2000 JOSHUA RD
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City | LAFAYETTE HILL
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State | PA
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Zip | 19444-2430
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Country | US
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Telephone | 610-260-1125
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Fax | 610-260-0931
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Authorized Official
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Title or Position | DIRECTOR OF ACCOUNTS RECEIVABLE
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Name | GWEN ELLEN VANGELISTO
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Credential |
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Telephone | 949-463-0893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | A93040
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License Number State | PA
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