Provider Demographics
NPI:1326660895
Name:LIFE AT ST. FRANCIS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:LIFE AT ST. FRANCIS HEALTHCARE, INC.
Other - Org Name:SAINT FRANCIS LIFE COLLEGE AVENUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR QA, COMPLIANCE, CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:CLARE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MS
Authorized Official - Phone:302-747-3336
Mailing Address - Street 1:1072 JUSTISON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-5162
Mailing Address - Country:US
Mailing Address - Phone:302-421-4956
Mailing Address - Fax:302-575-8239
Practice Address - Street 1:30 EXECUTIVE DRIVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702
Practice Address - Country:US
Practice Address - Phone:302-660-3351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization