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LORI DECARLO COTA/L

Adult Care Home

Aston, Pennsylvania

Provider NPI: 1164755625

Provider Information:
 LORI  DECARLO COTA/L


Practice Location:
696A LENNI RD  ASTON, PA 19014 US
Tel: 610-459-2046  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
PAOP001599L

Other Provider Identifiers:

IssuerNumberStateType
AOTAOP001599LPA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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