Provider Demographics
NPI:1073281002
Name:ALBRIGHT LIFE
Entity Type:Organization
Organization Name:ALBRIGHT LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:TERRENCE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:570-522-3889
Mailing Address - Street 1:90 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-6307
Mailing Address - Country:US
Mailing Address - Phone:570-522-3880
Mailing Address - Fax:570-522-3836
Practice Address - Street 1:555 FOX CHASE STE 106
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1885
Practice Address - Country:US
Practice Address - Phone:484-378-1214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBRIGHT LIFE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization