MEDICARE: ALENTA SERVICE COORDINATION AGENCY

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		PA

General Provider Information

NPI Number	:	1386163988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALENTA SERVICE COORDINATION AGENCY

Provider Business Mailing Address
First Line	:	PO BOX 803
Second Line	:
City	:	SPRING HOUSE
State	:	PA
Zip	:	19477-0803
Country	:	US
Telephone Number	:	484-843-1816
Fax Number	:

Provider Business Practice Location Address
First Line	:	5203 AVENEL BLVD
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-3956
Country	:	US
Telephone Number	:	484-843-1816
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	ENEIDA MASKUTI
Credential	:
Telephone Number	:	484-843-1816

Provider Enumeration Date	:	09/14/2017
Last Update Date	:	03/17/2018

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