NPI 1720443898

Divine Providence Village

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

Practice location

Address: 412 Perry St, Ridley Park, PA 19078-3725
Phone: (610) 543-3380
Mailing address: 686 Old Marple Rd, Springfield, PA 19064-1239

Authorised official

Name: Fran Swiacki
Title: Divisional Director
Phone: (610) 543-3380

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: 1720443898
Entity type: Organization
NPI issued: 16 Dec 2015
Record last updated: 16 Dec 2015

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.