Divine Providence Village in Ardmore - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Divine Providence Village - NPI 1629196639
Divine Providence Village is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Ardmore, 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 1629196639. The last update date is 2015-11-13.
Divine Providence Village's current location address is 617 Hazelwood Rd, Ardmore, Pennsylvania. You can contact this provider via phone number 6105435410 and fax number 6105435397. The mailing address for Divine Providence Village is 617 Hazelwood Rd, Ardmore, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Divine Providence Village |
|---|---|
| Address | 617 Hazelwood Rd, Ardmore, 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 | 1629196639 |
|---|---|
| Provider Enumeration Date | 2007-03-27 |
| Last Updated Date | 2015-11-13 |
Provider Mailing Address Detail
| Address | 617 Hazelwood Rd |
|---|---|
| City | Ardmore |
| State | Pennsylvania (PA) |
| Post Code | 190031817 |
| 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 |
|---|---|---|---|
| 1000031590120 | PA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Divine Providence Village by the Centers for Medicare & Medicaid Services (CMS)?
The Divine Providence Village has been assigned the NPI (National Provider Identifier) 1629196639. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Divine Providence Village's physical address?
The Divine Providence Village is physically located at 617 Hazelwood Rd, in the city of Ardmore, PA, with the postal code 190031817.
What is Divine Providence Village's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Divine Providence Village is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the taxonomy code that categorizes this field of expertise is 320900000X.
On what date did the Divine Providence Village receive the assignment of its 1629196639 from the Centers for Medicare & Medicaid Services?
The Divine Providence Village was issued its 1629196639 by the Centers for Medicare & Medicaid Services on 2007-03-27.
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.