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LUTHERAN HOME FOR THE AGED
NPI 1891980355
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization in Erie, PA

Active since September 07, 2007CLIA Certified · 5 labs
149 W 22ND ST, ERIE, PA 16502(814) 452-3271(814) 456-9232 Get Directions Write a Review

NPPES record last updated: November 16, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lutheran Home For The Aged NPPES

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

LUTHERAN HOME FOR THE AGED (NPI 1891980355) is a healthcare organization registered as a program of all-inclusive care for the elderly (pace) provider organization in Erie, Pennsylvania and active in the NPI registry since September 2007. The organization holds 5 active CLIA laboratory certificates and lists Mark J. Gusek, Ceo, as its authorized official.

NPPES Registry Identity

NPI1891980355
Entity TypeOrganization
Primary Taxonomy251T00000X
Legal Business NameLIFE-NORTHWESTERN PENNSYLVANIA
Location Address149 W 22ND STErie, PA 16502-2804
Mailing Address100 State St Ste 200Erie, PA 16507-1454 · (814) 456-5433 · Fax (814) 454-2500
Phone(814) 452-3271
Fax(814) 456-9232
Organization SubpartNo
Authorized OfficialMark J. GusekCeo · (814) 456-5433
Enumeration DateSeptember 7, 2007
Last NPPES UpdateNovember 16, 2020
NPPES CertifiedNovember 16, 2020
✔ NPI 1891980355 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.
149 W 22ND ST, Erie, PA 16502
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Other Names 1

Other NameLutheran Home For The Aged

Other Identifiers 1

Medicaid1007767250005PA

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2029832

Life Northwestern Pennsylvania-Erie · Erie, PA
Active · expires Sep 14, 2027
CLIA Number39D2029832
Laboratory TypeAdult Day Care
Certificate Effective DateSeptember 15, 2025
Certificate Expiration DateSeptember 14, 2027
Laboratory DirectorDr. Rawand Khader
Laboratory Phone(814) 456-5433
Laboratory LocationLife Northwestern Pennsylvania-Erie121 West 12th Street, Erie, PA 16501
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 39D2229914

Life Northwestern Pennsylvania - Clearfield · Clearfield, PA
Active · expires Jul 18, 2027
CLIA Number39D2229914
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJuly 19, 2025
Certificate Expiration DateJuly 18, 2027
Laboratory DirectorDr. Rawand Khader
Laboratory Phone(814) 456-5433
Laboratory LocationLife Northwestern Pennsylvania - Clearfield103 N Front Street, Clearfield, PA 16830
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 39D2132008

Life Northwestern Pennsylvania-Warren · Warren, PA
Active · expires Jun 8, 2027
CLIA Number39D2132008
Laboratory TypeAdult Day Care
Certificate Effective DateJune 9, 2025
Certificate Expiration DateJune 8, 2027
Laboratory DirectorDr. Kevin Shaffer
Laboratory Phone(814) 456-5433
Laboratory LocationLife Northwestern Pennsylvania-Warren1885 Market Street, Suite C, Warren, PA 16365
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 39D2121101

Life Northwestern Pennsylvania-Mercer · Sharon, PA
Active · expires Oct 30, 2026
CLIA Number39D2121101
Laboratory TypeAdult Day Care
Certificate Effective DateOctober 31, 2024
Certificate Expiration DateOctober 30, 2026
Laboratory DirectorDr. Kevin Shaffer
Laboratory Phone(814) 456-5433
Laboratory LocationLife Northwestern Pennsylvania-Mercer80 East Silver Street, 4th Floor, Sharon, PA 16146
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 39D2117588

Life Northwestern Pennsylvania-Crawford · Meadville, PA
Active · expires Aug 18, 2026
CLIA Number39D2117588
Laboratory TypeAdult Day Care
Certificate Effective DateAugust 19, 2024
Certificate Expiration DateAugust 18, 2026
Laboratory DirectorDr. Kevin Shaffer
Laboratory Phone(814) 456-5433
Laboratory LocationLife Northwestern Pennsylvania-Crawford1119 Park Avenue, Meadville, PA 16335
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

THE LUTHERAN HOME FOR THE AGED D/B/A THE VILLAGE AT LUTHER SQUARE
Skilled Nursing Facility
149 W 22ND ST
ERIE, PA 16502
Erie County (814) 456-5433
MARY WHIPPLE
Nurse Practitioner (Family)
149 W 22ND ST
ERIE, PA 16502
Erie County (814) 456-5433
DIANE BOYD
Nurse Practitioner (Family)
149 W 22ND ST
ERIE, PA 16502
Erie County (814) 384-0168
DR. KEVIN P SHAFFER MD
Family Medicine
149 W 22ND ST
ERIE, PA 16502
Erie County (814) 456-5433
LECOM AT VILLAGE SQUARE, LLC
Skilled Nursing Facility
149 W 22ND ST
ERIE, PA 16502
Erie County (814) 452-3271
GLENN ROBERT WOLFE COTA/L
Occupational Therapy Assistant
149 W 22ND ST
ERIE, PA 16502
Erie County (814) 452-3271
LUTHERAN HOME FOR THE AGED
Skilled Nursing Facility
149 W 22ND ST
ERIE, PA 16502
Erie County (814) 452-3271

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 Life-Northwestern Pennsylvania's NPI number?

The NPI number for Life-Northwestern Pennsylvania is 1891980355. It was assigned to this organization in the NPPES registry on September 7, 2007. The provider is also known as Lutheran Home For The Aged.

Where is Life-Northwestern Pennsylvania located?

Life-Northwestern Pennsylvania is located at 149 W 22nd St, Erie, PA 16502. The listed phone number is (814) 452-3271.

What is Life-Northwestern Pennsylvania'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.

Does Life-Northwestern Pennsylvania hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Life-Northwestern Pennsylvania was last updated on November 16, 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.