Divine Providence Village in Philadelphia - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Divine Providence Village - NPI 1063539658
Divine Providence Village is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Philadelphia, Pennsylvania. Divine Providence Village practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Divine Providence Village is 1063539658. The last update date is 2015-11-13.
Divine Providence Village's current location address is 221 E Montana St, Philadelphia, Pennsylvania. You can contact this provider via phone number 6105435410 and fax number 6105435397. The mailing address for Divine Providence Village is 221 E Montana St, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Divine Providence Village |
|---|---|
| Address | 221 E Montana St, Philadelphia, Pennsylvania |
| Phone Number | 6105435410 |
| Fax Number | 6105435397 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIVISIONAL |
|---|---|
| Authorized Official Name | Swiacki Fran |
| Telephone Number | 6105433380 |
NPI Number Detail
| NPI Number | 1063539658 |
|---|---|
| Provider Enumeration Date | 2007-03-26 |
| Last Updated Date | 2015-11-13 |
Provider Mailing Address Detail
| Address | 221 E Montana St |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191192260 |
| Phone Number | 6105435410 |
| Fax Number | 6105435397 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320900000X |
|
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1000031590104 | PA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Divine Providence Village by the Centers for Medicare & Medicaid Services?
The Divine Providence Village has been assigned the NPI (National Provider Identifier) 1063539658 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Divine Providence Village is located?
The Divine Providence Village is situated at the following address: 221 E Montana St, Philadelphia, PA, 191192260.
What is the area of specialization for Divine Providence Village, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Divine Providence Village is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this area of expertise is 320900000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1063539658 to Divine Providence Village?
The Centers for Medicare & Medicaid Services originally issued the 1063539658 to Divine Providence Village on 2007-03-26.
When was the information related to Divine Providence Village most recently updated or refreshed?
The details pertaining to the Divine Providence Village, including its address, specialty, and other relevant information, were last updated or refreshed on 2015-11-13.
NPI Number: 1184627523
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