NPIMap

Divine Providence Village

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

NPI 1780049320 · NPPES record last updated Apr 5, 2024

Key facts

NPI
1780049320
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
215 Fairlamb Ave
Havertown, PA 19083-2822
Phone
(610) 543-3380
NPI assigned
Dec 28, 2015
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 Yes

Addresses

Primary practice location

215 Fairlamb Ave
Havertown, PA 19083-2822

Mailing address

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

Other providers in Havertown, PA

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

Sources for this page

Verify at the official NPI Registry.