Organization · Type 2 NPI

Providence Living LLC

Substance Use Disorder Rehabilitation Clinic/Center · Philadelphia, PA

NPI number 1962965145 Active

Practice location

1528 Walnut St Ste 1410
Philadelphia, PA 19102-3610

Call (484) 445-4145 Map

Fax (888) 373-9844

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Mental Health Counselor 101YM0800XNone listed
Adult Mental Health Clinic/Center 261QM0850XNone listed
Substance Use Disorder Rehabilitation Clinic/Center Primary 261QR0405XNone listed
Substance Abuse Rehabilitation Facility 324500000XNone listed

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About NPI 1962965145

Providence Living LLC's National Provider Identifier is 1962965145, issued on Apr 13, 2019. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Philadelphia, PA. The record was last updated on Aug 25, 2025.