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Divine Providence Village

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · West Norriton, PA

NPI 1104943877 · NPPES record last updated Mar 28, 2024

Key facts

NPI
1104943877
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
1741 Magnolia LN
West Norriton, PA 19403-3323
Phone
(610) 543-5410
Fax
(610) 543-5397
NPI assigned
Mar 26, 2007
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Divine Providence Village (124 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X PA Yes

Addresses

Primary practice location

1741 Magnolia LN
West Norriton, PA 19403-3323

Mailing address

686 Old Marple Rd
Springfield, PA 19064-1239
Phone (610) 328-7730

Other identifiers

IdentifierTypeStateIssuer
1000031590123MedicaidPA

Other providers in West Norriton, PA

All providers in West Norriton, PA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pennsylvania

Sources for this page

Verify at the official NPI Registry.