NPIMap

Organization Active NPI

Divine Providence Village

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Springfield, PA
National Provider Identifier
1669599874
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
DIVINE PROVIDENCE VILLAGE
Practice address
686 Old Marple Rd
Springfield, PA 19064-1239
Phone
(610) 328-7730
Fax
(610) 544-1710
NPI assigned
Mar 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Mark E Fitzgerald, NHA, MSW
Title
Director, Mr Services
Phone
(610) 543-6602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X PA Primary

Addresses

Primary practice location

686 Old Marple Rd
Springfield, PA 19064-1239

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1000031590003MedicaidPA

Other names 1

  • DPV Respite Other name

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": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669599874",
    "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": "610-328-7730",
            "fax_number": "610-544-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 OLD MARPLE RD",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190641239",
            "telephone_number": "610-328-7730",
            "fax_number": "610-544-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR, MR SERVICES",
        "authorized_official_telephone_number": "610-543-6602",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA, MSW"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000031590003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DPV Respite",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.