Provider Demographics
NPI:1134113392
Name:COUNTY OF CHESTER DEPARTMENT OF AGING
Entity Type:Organization
Organization Name:COUNTY OF CHESTER DEPARTMENT OF AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPATMENT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LUBA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-344-6009
Mailing Address - Street 1:601 WESTTOWN RD
Mailing Address - Street 2:SUITE 320 PO BOX 2747
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4958
Mailing Address - Country:US
Mailing Address - Phone:610-344-6009
Mailing Address - Fax:
Practice Address - Street 1:601 WESTTOWN RD
Practice Address - Street 2:SUITE 320
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4958
Practice Address - Country:US
Practice Address - Phone:610-344-6009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007655340029Medicaid