Divine Providence Village in Philadelphia - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Divine Providence Village - NPI 1255459657
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 1255459657. The last update date is 2015-11-13.
Divine Providence Village's current location address is 7002 Henry Ave, Philadelphia, Pennsylvania. You can contact this provider via phone number 6105435410 and fax number 6105435397. The mailing address for Divine Providence Village is 7002 Henry Ave, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Divine Providence Village |
|---|---|
| Address | 7002 Henry 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 | 1255459657 |
|---|---|
| Provider Enumeration Date | 2007-03-26 |
| Last Updated Date | 2015-11-13 |
Provider Mailing Address Detail
| Address | 7002 Henry Ave |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191281524 |
| 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 |
|---|---|---|---|
| 1000031590066 | PA | -- |
Post Comment/ Review Below
What is the Divine Providence Village's 1255459657?
The Divine Providence Village's NPI (National Provider Identifier) Number is 1255459657. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Divine Providence Village is located?
The Divine Providence Village is situated at the following address: 7002 Henry Ave, Philadelphia, PA, 191281524.
What is Divine Providence Village's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Divine Providence Village's specialized field of practice is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this area of specialization is 320900000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1255459657 to Divine Providence Village?
The Centers for Medicare & Medicaid Services originally issued the 1255459657 to Divine Providence Village on 2007-03-26.
When was the information regarding Divine Providence Village, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Divine Providence Village, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2015-11-13.