Provider Demographics
NPI:1144543463
Name:SENIOR LIFE STYLES
Entity type:Organization
Organization Name:SENIOR LIFE STYLES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING AND REIMBURSEME
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:HALAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-417-2687
Mailing Address - Street 1:131 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914
Mailing Address - Country:US
Mailing Address - Phone:215-822-7888
Mailing Address - Fax:215-822-6160
Practice Address - Street 1:131 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2918
Practice Address - Country:US
Practice Address - Phone:215-822-7888
Practice Address - Fax:215-822-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1268313104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1006808020001Medicaid