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INNOVAGE PENNSYLVANIA LIFE, LLC
NPI 1023612264
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization in Philadelphia, PA

Active since November 29, 2020
3232 HENRY AVE, PHILADELPHIA, PA 19129(267) 774-2920 Get Directions Write a Review

NPPES record last updated: November 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Innovage Pennsylvania Life, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INNOVAGE PENNSYLVANIA LIFE, LLC (NPI 1023612264), doing business as Innovage Pennsylvania Life- Henry Avenue, is a healthcare organization registered as a program of all-inclusive care for the elderly (pace) provider organization in Philadelphia, Pennsylvania and active in the NPI registry since November 2020. The organization lists Lezlie Corbin, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1023612264
Entity TypeOrganization
Primary Taxonomy251T00000X
Legal Business NameINNOVAGE PENNSYLVANIA LIFE, LLC
Location Address3232 HENRY AVEPhiladelphia, PA 19129-1241
Mailing Address8950 E Lowry BlvdDenver, CO 80230-7030 · (215) 734-9587
Phone(267) 774-2920
Organization SubpartYes
Authorized OfficialLezlie CorbinCredentialing Coordinator · (215) 734-9587
Enumeration DateNovember 29, 2020
NPPES CertifiedNovember 29, 2020
✔ NPI 1023612264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProgram of All-Inclusive Care for the Elderly (PACE) Provider OrganizationAgencies
Taxonomy Code251T00000X
Definition
A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.
3232 HENRY AVE, Philadelphia, PA 19129
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Other Names 1

Doing Business AsInnovage Pennsylvania Life- Henry Avenue

Other Identifiers 1

Medicaid101734256-0005PA

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RARITAN DIALYSIS LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
3232 HENRY AVE
PHILADELPHIA, PA 19129
Philadelphia County (267) 876-4258

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Innovage Pennsylvania Life, LLC's NPI number?

The NPI number for Innovage Pennsylvania Life, LLC is 1023612264. It was assigned to this organization in the NPPES registry on November 29, 2020. The provider is doing business as InnovAge Pennsylvania LIFE- Henry Avenue.

Where is Innovage Pennsylvania Life, LLC located?

Innovage Pennsylvania Life, LLC is located at 3232 Henry Ave, Philadelphia, PA 19129. The listed phone number is (267) 774-2920.

What is Innovage Pennsylvania Life, LLC's specialty?

The primary specialty registered for this NPI is Program of All-Inclusive Care for the Elderly (PACE) Provider Organization with taxonomy code 251T00000X.

When was this NPI record last updated?

The NPPES record for Innovage Pennsylvania Life, LLC was last updated on November 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.