Provider Demographics
NPI:1245384411
Name:LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC
Entity type:Organization
Organization Name:LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-388-8042
Mailing Address - Street 1:875 GREENTREE ROAD
Mailing Address - Street 2:ONE PARKWAY CENTER, SUITE 200
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220
Mailing Address - Country:US
Mailing Address - Phone:412-388-8042
Mailing Address - Fax:412-388-8055
Practice Address - Street 1:875 GREENTREE ROAD
Practice Address - Street 2:ONE PARKWAY CENTER, SUITE 200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220
Practice Address - Country:US
Practice Address - Phone:412-388-8042
Practice Address - Fax:412-388-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA062880251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001705841Medicaid
PA001705841Medicaid