Organization · Type 2 NPI

Divine Providence Village

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Philadelphia, PA

NPI number 1063530756 Active

Practice location

1804 Dallas St
Philadelphia, PA 19126-1519

Call (610) 543-5410 Map

Fax (610) 543-5397

Mailing address

686 Old Marple Rd
Springfield, PA 19064-1239

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1063530756

Divine Providence Village's National Provider Identifier is 1063530756, issued on Mar 27, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Philadelphia, PA. The record was last updated on Mar 28, 2024.