| NPI | 1588279657 |
|---|---|
| Doing Business As | INNOVAGE PENNSYLVANIA LIFE-PENNYPACK |
| Entity Type | Organization |
| Authorized Contact | VANESSA DEBORAH WALTON Chief Legal Officer 303-242-1352 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251T00000X PACE Provider Organization |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |