Provider Demographics
NPI:1326338419
Name:PLANNED LIFETIME ASSISTANCE NETWORK OF PENNSYLVANIA
Entity Type:Organization
Organization Name:PLANNED LIFETIME ASSISTANCE NETWORK OF PENNSYLVANIA
Other - Org Name:PLAN OF PA
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-687-4036
Mailing Address - Street 1:110 W LANCASTER AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-4043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 W LANCASTER AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-4043
Practice Address - Country:US
Practice Address - Phone:610-687-4036
Practice Address - Fax:610-687-2716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW014191251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management