NPI 1013372184

Divine Providence Village

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

Practice location

Address: 6221 N 11th St, Philadelphia, PA 19141-3301
Phone: (610) 543-3380
Mailing address: 686 Old Marple Rd, Springfield, PA 19064-1239

Authorised official

Name: Dawn Engel
Title: Hipaa Officer
Phone: (610) 525-8800

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

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Registry record

NPI: 1013372184
Entity type: Organization
NPI issued: 16 Dec 2015
Record last updated: 28 Mar 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.