| Typical Life Corporation | |
|
707 Loucks Rd York PA 17404-1730 | |
| (717) 718-1215 | |
| (717) 854-5007 |
| Full Name | Typical Life Corporation |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 707 Loucks Rd, York, Pennsylvania |
| Authorized Official Name and Position | Vicki Sue Miller (CFO) |
| Authorized Official Contact | 7177181215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Typical Life Corporation 707 Loucks Rd York PA 17404-1730 Ph: (717) 718-1215 | Typical Life Corporation 707 Loucks Rd York PA 17404-1730 Ph: (717) 718-1215 |
| NPI Number | 1992253702 |
|---|---|
| Provider Enumeration Date | 09/21/2016 |
| Last Update Date | 09/21/2016 |
| Medicare PECOS PAC ID | 4789969346 |
|---|---|
| Medicare Enrollment ID | O20170322000015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992253702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 332920 (Pennsylvania) | Primary |
| Provider Name | Nikita J Eike |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104243096 PECOS PAC ID: 9133342561 Enrollment ID: I20140603001420 |
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