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31D2122781 CLIA NUMBER - ATLANTICARE HEALTH SERVICES, INC DBA ATLANTICARE LIFE CONNECTION

Laboratory Demographics

CLIA Number: 31D2122781

Facility Name: ATLANTICARE HEALTH SERVICES, INC DBA ATLANTICARE LIFE CONNECTION

Facility Address:
1401 ATLANTIC AVENUE
ATLANTIC CITY, NJ
ZIP 08401
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Facility Phone Number: 609 407-2052

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver
NPI Number: 1598207417

Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization
A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.

CLIA Record

Field Name Field Value
CLIA Number 31D2122781
LAB Type Comp. Outpatient Rehab Facility
Facility Name ATLANTICARE HEALTH SERVICES, INC DBA ATLANTICARE LIFE CONNECTION
Street 1401 ATLANTIC AVENUE
City ATLANTIC CITY
State NJ
ZIP 08401
Phone 609 407-2052
CertificateType 4
CertificateEffectiveDate 12/6/2022
CertificateExpirationDate 12/5/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024