Divine Providence Village in Philadelphia - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities

Divine Providence Village - NPI 1710005400

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 1710005400. The last update date is 2015-11-16.

Divine Providence Village's current location address is 6126 N 11th St, Philadelphia, Pennsylvania. You can contact this provider via phone number 6105435410 and fax number 6105435397. The mailing address for Divine Providence Village is 6126 N 11th St, Philadelphia, Pennsylvania. To know further, please read the information below!

Provider Profile Detail

Provider Organization Divine Providence Village
Address 6126 N 11th 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 1710005400
Provider Enumeration Date 2007-03-27
Last Updated Date 2015-11-16

Provider Mailing Address Detail

Address 6126 N 11th St
City Philadelphia
State Pennsylvania (PA)
Post Code 191413318
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
1000031590064 PA --

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FAQs about Divine Providence Village

What is the Divine Providence Village's unique identification number?

The Divine Providence Village has been assigned the NPI (National Provider Identifier) Number 1710005400 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.

Could you provide the complete physical address where Divine Providence Village is located?

The Divine Providence Village is situated at the following address: 6126 N 11Th St, Philadelphia, PA, 191413318.

What is Divine Providence Village's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?

The primary field of medical specialization for Divine Providence Village is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the taxonomy classification code that categorizes this area of expertise is 320900000X.

When did Divine Providence Village receive its 1710005400 assignment?

The Divine Providence Village was assigned its 1710005400 on 2007-03-27, which is the date when this unique identifier was issued to the organization.

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 2015-11-16.

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