Provider Demographics
NPI:1194247759
Name:PLUM SENIOR COMMUNITY CENTER
Entity type:Organization
Organization Name:PLUM SENIOR COMMUNITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:SEGELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-795-2330
Mailing Address - Street 1:499 CENTER NEW TEXAS RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-1819
Mailing Address - Country:US
Mailing Address - Phone:412-795-2330
Mailing Address - Fax:412-795-4199
Practice Address - Street 1:499 CENTER NEW TEXAS ROAD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239-1819
Practice Address - Country:US
Practice Address - Phone:412-795-2330
Practice Address - Fax:412-795-4199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033137270001Medicaid