Divine Providence Village in Philadelphia - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Divine Providence Village - NPI 1164549747
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 1164549747. The last update date is 2015-11-13.
Divine Providence Village's current location address is 7265 Cornelius St, Philadelphia, Pennsylvania. You can contact this provider via phone number 6105435410 and fax number 6105435397. The mailing address for Divine Providence Village is 7265 Cornelius St, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Divine Providence Village |
|---|---|
| Address | 7265 Cornelius 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 | 1164549747 |
|---|---|
| Provider Enumeration Date | 2007-03-26 |
| Last Updated Date | 2015-11-13 |
Provider Mailing Address Detail
| Address | 7265 Cornelius St |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191381629 |
| 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. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1000031590117 | PA | -- |
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What is the unique identification code assigned to Divine Providence Village by the Centers for Medicare & Medicaid Services?
The Divine Providence Village has been issued the NPI (National Provider Identifier) 1164549747. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Divine Providence Village's facilities are situated?
The facilities of Divine Providence Village are physically located at the following address: 7265 Cornelius St, Philadelphia, PA, 191381629.
What is Divine Providence Village's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Divine Providence Village is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the taxonomy code that classifies this field of practice is 320900000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1164549747 to Divine Providence Village?
The Divine Providence Village received its 1164549747 assignment from the Centers for Medicare & Medicaid Services on 2007-03-26.
As of what date were the Divine Providence Village's details last updated?
The information pertaining to the Divine Providence Village, including its address, specialty, and other details, was most recently updated on 2015-11-13.