Divine Providence Village
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Lansdowne, PA
NPI 1003934860 · NPPES record last updated Mar 28, 2024
Key facts
- NPI
- 1003934860
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- DIVINE PROVIDENCE VILLAGE
- Practice address
- 120 Nyack Ave
Lansdowne, PA 19050-2918 - Phone
- (484) 475-2465
- Fax
- (610) 543-5397
- NPI assigned
- Mar 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Fran Swiacki
- Title
- Divisional Director
- Phone
- (610) 543-3380
Corporate family (same tax ID) 14
National Provider Directory
- Tax ID family
- Divine Providence Village
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | PA | Yes |
Addresses
Primary practice location
120 Nyack Ave
Lansdowne, PA 19050-2918
Mailing address
686 Old Marple Rd
Springfield, PA 19064-1239
Phone (610) 328-7730
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000031590126 | Medicaid | PA |
Other providers in Lansdowne, PA
- Davis Socio-Psychological Services, LLC
- Mark Alan Davis Sr.
- Mark Dean
- Deirdre Razzi, LCSW, LLC
- Yourcenar Destin
- Divine Providence Village
- Divine Providence Village
- Divine Providence Village
- Divine Providence Village
- Divine Providence Village
All providers in Lansdowne, PA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.