Provider Demographics
NPI:1851945588
Name:PCA CARE CONNECTIONS
Entity Type:Organization
Organization Name:PCA CARE CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-282-6500
Mailing Address - Street 1:642 N BROAD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3424
Mailing Address - Country:US
Mailing Address - Phone:215-282-6500
Mailing Address - Fax:215-282-6620
Practice Address - Street 1:642 N BROAD ST STE 300
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3424
Practice Address - Country:US
Practice Address - Phone:215-282-6500
Practice Address - Fax:215-282-6620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103620497-001Medicaid