Communities of Don Guanella and Divine Providence
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Secane, PA
NPI 1003949157 · NPPES record last updated Mar 26, 2024
Key facts
- NPI
- 1003949157
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- COMMUNITIES OF DON GUANELLA AND DIVINE PROVIDENCE
- Practice address
- 10 Fatima Dr
Secane, PA 19018-4640 - Phone
- (610) 543-3380
- NPI assigned
- Mar 14, 2007
- Organization subpart
- No
Authorized official
- Name
- Dawn Engel
- Title
- Hipaa Officer
- Phone
- (484) 908-6057
Corporate family (same tax ID) 15
National Provider Directory
- Tax ID family
- Divine Providence Village
Locations
10 Fatima Dr
Secane, PA 19018
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
10 Fatima Dr
Secane, PA 19018-4640
Mailing address
20 E Cleveland Ave
Norwood, PA 19074-1207
Phone (610) 543-3380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000031400002 | Medicaid | PA |
Other names
- Don Guanella Village Work Activity Center
Other providers in Secane, PA
- Madeline Mary Byrne
- Nina Chen
- Ntumba Chibola
- Jeremy Cochran
- Kelsey Collevechio
- Samantha Bowen Cooper
- Faranak Dabir
- Jeffrey Dickinson
- Ashley Dilullo
- Divine Providence Village
All providers in Secane, 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 26, 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.