Divine Providence Village

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

DIVINE PROVIDENCE VILLAGE

Practice address

714 Belfield Ave
Drexel Hill, PA 19026-4306

Phone

(610) 543-6602

NPI assigned

Mar 31, 2014

Last updated

Nov 2, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Fran Swiacki

Title

Divisional Director

Phone

(610) 543-6602

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1265850994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 OLD MARPLE RD",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190641239",
            "telephone_number": "610-543-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 BELFIELD AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190264306",
            "telephone_number": "610-543-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-31",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "SWIACKI",
        "authorized_official_first_name": "FRAN",
        "authorized_official_title_or_position": "DIVISIONAL DIRECTOR",
        "authorized_official_telephone_number": "610-543-6602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• DJK Rehab, Inc
• Stephen Tyler Dougherty
• Dr. Robert C Madonna Associates PC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Drexel Hill, PA
• Providers in Drexel Hill, PA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.