Provider Demographics
NPI:1619235934
Name:LIFE AT ST. FRANCIS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:LIFE AT ST. FRANCIS HEALTHCARE, INC.
Other - Org Name:ST. FRANCIS LIFE COLLEGE AVENUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:QUALITY & COMPLIANCE DIRECTOR
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,BS, MS, MJ
Authorized Official - Phone:302-660-3359
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:302-660-3351
Mailing Address - Fax:302-575-8239
Practice Address - Street 1:1072 JUSTISON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5162
Practice Address - Country:US
Practice Address - Phone:302-421-4956
Practice Address - Fax:302-575-8239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE251T00000X251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEH5493OtherCMS PACE NUMBER