Provider Demographics
NPI:1720692767
Name:LIFE FORCE FOR OLDER AMERICANS
Entity type:Organization
Organization Name:LIFE FORCE FOR OLDER AMERICANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:EVEREKLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-356-1943
Mailing Address - Street 1:3544 W CHESTER PIKE STE 216
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4107
Mailing Address - Country:US
Mailing Address - Phone:610-356-1943
Mailing Address - Fax:
Practice Address - Street 1:1869 HAWK CT
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-3114
Practice Address - Country:US
Practice Address - Phone:410-240-4517
Practice Address - Fax:610-359-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility