Divine Providence Village in Philadelphia - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Divine Providence Village - NPI 1790803492
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 1790803492. The last update date is 2015-11-16.
Divine Providence Village's current location address is 6322 N 21st St, Philadelphia, Pennsylvania. You can contact this provider via phone number 6105435410 and fax number 6105435397. The mailing address for Divine Providence Village is 6322 N 21st St, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Divine Providence Village |
|---|---|
| Address | 6322 N 21st 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 | 1790803492 |
|---|---|
| Provider Enumeration Date | 2007-03-27 |
| Last Updated Date | 2015-11-16 |
Provider Mailing Address Detail
| Address | 6322 N 21st St |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191383006 |
| 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 |
|---|---|---|---|
| 1000031590110 | PA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Divine Providence Village by the Centers for Medicare & Medicaid Services?
The Divine Providence Village has been assigned the NPI (National Provider Identifier) 1790803492 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Where is the Divine Providence Village located?
The Divine Providence Village is located at 6322 N 21St St, Philadelphia, PA 191383006.
What is the area of specialization for Divine Providence Village, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Divine Providence Village is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this area of expertise is 320900000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1790803492 to Divine Providence Village?
The Centers for Medicare & Medicaid Services assigned the 1790803492 to Divine Providence Village on 2007-03-27.
When was the information pertaining to Divine Providence Village most recently updated or revised?
The details related to Divine Providence Village, including its address, specialty, and other relevant information, were last updated or revised on 2015-11-16.