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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	BORA PHASE II LLC
Address:	121 BRENTWOOD DR WILLOW GROVE, PA 19090-3712
Phone:	(215) 668-1289
Fax:	(215) 252-5007
E-mail:	MTADPRIMA@GMAIL.COM
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

Click here to view Provider Certification Information

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PROVIDER'S PARENT/ REGIONAL OFFICE Supporting line for group header


Type:	Corporate Office
Name:	BORA PHASE II LLC
Address:	5150 RIDGE AVE # 104 PHILADELPHIA, PA 19128-3797
Phone:	(215) 668-1289

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Bucks
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Butler
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Cambria
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Cameron/Elk
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Carbon/Monroe/Pike
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Centre
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Chester
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Clarion
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Clearfield/Jefferson
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Columbia/Montour/Snyder/Union
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Crawford
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Cumberland/Perry
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Dauphin
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Delaware
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Montgomery
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

County : Philadelphia
\|Service Name / Level	\|Rate

Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$869.48 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic- 15-min (Basic 1:4)	$2.44 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd)	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD	$13.28 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE	$13.28 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$8.59 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TD	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enh) - TE	$21.74 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced)	$21.74 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$17.03 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home	$97.84 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$531.24 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$869.48 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$681.46 / 1 Day

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