Provider Demographics
NPI:1306116280
Name:GREATER PITTSBURGH ASSISTED LIVING SERVICES, INC.
Entity type:Organization
Organization Name:GREATER PITTSBURGH ASSISTED LIVING SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FRANCHISE OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVELLY
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:412-595-7554
Mailing Address - Street 1:2000 OXFORD DR
Mailing Address - Street 2:SUITE 470
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1827
Mailing Address - Country:US
Mailing Address - Phone:412-595-7554
Mailing Address - Fax:412-595-7881
Practice Address - Street 1:2000 OXFORD DR
Practice Address - Street 2:SUITE 470
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1827
Practice Address - Country:US
Practice Address - Phone:412-595-7554
Practice Address - Fax:412-595-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA15153601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011288820001Medicaid
PA1011288820002Medicaid