Divine Providence Village in Philadelphia - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Divine Providence Village - NPI 1063530756
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 1063530756. The last update date is 2015-11-16.
Divine Providence Village's current location address is 5945 N Park Ave, Philadelphia, Pennsylvania. You can contact this provider via phone number 6105435410 and fax number 6105435397. The mailing address for Divine Providence Village is 5945 N Park Ave, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Divine Providence Village |
|---|---|
| Address | 5945 N Park Ave, 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 | 1063530756 |
|---|---|
| Provider Enumeration Date | 2007-03-27 |
| Last Updated Date | 2015-11-16 |
Provider Mailing Address Detail
| Address | 5945 N Park Ave |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191413217 |
| 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 |
|---|---|---|---|
| 1000031590092 | PA | -- |
Post Comment/ Review Below
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) 1063530756. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Divine Providence Village?
The Divine Providence Village is physically situated at 5945 N Park Ave, in the city of Philadelphia, state of PA, with the postal code 191413217.
What is Divine Providence Village's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Divine Providence Village is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy classification code for this specialized field is 320900000X.
When did the Divine Providence Village receive its 1063530756?
The Divine Providence Village was issued its 1063530756 on 2007-03-27, which is the date when the organization was assigned this unique identifier.
As of what date were the details related to Divine Providence Village most recently updated or revised?
The information pertaining to Divine Providence Village, including its address, specialty, and other relevant details, was last updated or revised on 2015-11-16.
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