NPIMap

Organization Active NPI

Communities of Don Guanella and Divine Providence

  • Intellectual Disabilities Intermediate Care Facility
  • Broomall, PA
National Provider Identifier
1265862858
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
COMMUNITIES OF DON GUANELLA AND DIVINE PROVIDENCE
Practice address
45 James Rd
Broomall, PA 19008-1411
Phone
(610) 543-3380
NPI assigned
Nov 18, 2013
Last updated
Mar 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

45 James Rd
Broomall, PA 19008-1411

Mailing address

20 E Cleveland Ave
Norwood, PA 19074-1207
Phone (610) 543-3380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265862858. Details of each certification follow.

  • CCN 39G442 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 39G442

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMMUNITIES OF DON GU AND DIVINE PRO AT JAME ROAD
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Apr 12, 2024
Last certification
Dec 4, 2025
Beds
4
Ownership / control type
Private (non-profit)
Facility address
45 James Road
Broomall, PA 19008

National Provider Directory

National Provider Directory
Tax ID family
Divine Providence Village124 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1265862858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E CLEVELAND AVE",
            "city": "NORWOOD",
            "state": "PA",
            "postal_code": "190741207",
            "telephone_number": "610-543-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 JAMES RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190081411",
            "telephone_number": "610-543-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITIES OF DON GUANELLA AND DIVINE PROVIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-18",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "ENGEL",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "HIPAA OFFICER",
        "authorized_official_telephone_number": "610-525-8800"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

Verify at the official NPI Registry.