MEDICARE: PLANNED LIFETIME ASSISTANCE NETWORK OF PENNSYLVANIA

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	251B00000X	Case Management Agency	CW014191	PA

General Provider Information

NPI Number	:	1326338419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED LIFETIME ASSISTANCE NETWORK OF PENNSYLVANIA

Provider Business Mailing Address
First Line	:	110 W LANCASTER AVE
Second Line	:	SUITE 140
City	:	WAYNE
State	:	PA
Zip	:	19087-4043
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 W LANCASTER AVE
Second Line	:	SUITE 140
City	:	WAYNE
State	:	PA
Zip	:	19087-4043
Country	:	US
Telephone Number	:	610-687-4036
Fax Number	:	610-687-2716

Authorized Official
Title or Position	:	DIRECTOR OF CLINICAL SERVICES
Name	:	NADINE HOCH
Credential	:
Telephone Number	:	610-687-4036

Provider Enumeration Date	:	04/11/2011
Last Update Date	:	04/11/2011

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Directions to “PLANNED LIFETIME ASSISTANCE NETWORK OF PENNSYLVANIA ” Practice Location

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