Divine Providence Village in Philadelphia - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Divine Providence Village - NPI 1710005418
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 1710005418. The last update date is 2015-11-16.
Divine Providence Village's current location address is 5438 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 5438 N 11th St, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Divine Providence Village |
|---|---|
| Address | 5438 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 | 1710005418 |
|---|---|
| Provider Enumeration Date | 2007-03-27 |
| Last Updated Date | 2015-11-16 |
Provider Mailing Address Detail
| Address | 5438 N 11th St |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191413005 |
| 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 |
|---|---|---|---|
| 1000031590083 | PA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Divine Providence Village?
The Divine Providence Village has been issued the NPI (National Provider Identifier) 1710005418 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Divine Providence Village located?
The Divine Providence Village is located at 5438 N 11Th St, Philadelphia, PA 191413005.
What is Divine Providence Village's specialized field of practice, and what is the corresponding taxonomy classification code?
The Divine Providence Village's area of specialization is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this field of practice is 320900000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1710005418 to Divine Providence Village?
The Divine Providence Village received its 1710005418 assignment from the Centers for Medicare & Medicaid Services on 2007-03-27.
When was the information regarding Divine Providence Village most recently updated?
The details pertaining to the Divine Providence Village, including its address, specialty, and other relevant information, were last refreshed on 2015-11-16.