Organization · Type 2 NPI

Divine Providence Village

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

NPI number 1386009454 Active

Practice location

1504 E Johnson St
Philadelphia, PA 19138-1110

Call (610) 543-3380 Map

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 1386009454

Divine Providence Village's National Provider Identifier is 1386009454, issued on Dec 16, 2015. 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 Apr 2, 2024.