DIVINE PROVIDENCE VILLAGE (NPI# 1255459657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255459657 |
| Entity Type | Organization |
| Organization Name | DIVINE PROVIDENCE VILLAGE |
| Practice Address |
7002 Henry Ave Philadelphia PA 19128-1524 |
| Mailing Address |
686 Old Marple Rd Springfield PA 19064-1239 |
| Practice Telephone | 6105435410 |
| Practice Fax Number | 6105435397 |
| Mailing Telephone | 6103287730 |
| Mailing Fax Number | 6105441710 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2015-11-13 |
| Authorized Official Name | MR. FRAN SWIACKI (DIVISIONAL DIRECTOR) |
| Authorized Official Telephone | 6105433380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | PA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1000031590066 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699130237 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19 James Rd, Broomall, PA 19008-1409 | 2015-12-28 |
| 1235594870 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8 Hinkson Blvd, Ridley Park, PA 19078-1828 | 2015-12-28 |
| 1144685785 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 58 Shelburne Rd, Springfield, PA 19064-2206 | 2015-12-28 |
| 1598120131 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 708 Bullock Ave, Yeadon, PA 19050-3501 | 2015-12-28 |
| 1780049320 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 215 Fairlamb Ave, Havertown, PA 19083-2822 | 2015-12-28 |
| 1871958413 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 33 S Madison Ave, Upper Darby, PA 19082-2818 | 2015-12-28 |
| 1154786796 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 202 E Maryland Ave, Aldan, PA 19018-3117 | 2015-12-28 |
| 1053776690 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1712 Shallcross Ave, Folcroft, PA 19032-1225 | 2015-12-28 |
| 1811352701 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 41 Media Line Rd, Apt. A-2, Broomall, PA 19008-1246 | 2015-12-21 |
| 1629433511 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 410 E Hinckley Ave, Apt. A-6, Ridley Park, PA 19078-2521 | 2015-12-21 |
| Street Address |
7002 HENRY AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19128-1524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851877179 | Andrew Mermelstein | Podiatrist | 5800 Roxborough Avenue, Philadelphia, PA 19128 | 2018-07-19 |
| 1811499361 | Ursula Wacyk | Social Worker | 6122 Ridge Avenue, Philadelphia, PW 19128 | 2018-03-01 |
| 1417478454 | Chelsea Lynn Roberts | Physician Assistant | 707 Autumn River Run, Philadelphia, PA 19128 | 2017-06-29 |
| 1174060503 | Melody Ann Piranian | Nurse Practitioner | Andorra Pediatrics, 8945 Ridge Ave St 5, Phila, PA 19128 | 2017-01-24 |
| 1154874410 | Meghan Smith | Pharmacist | 5927-59 Ridge Ave, Philadelphia, PA 19128 | 2016-08-03 |
| 1356797880 | Jenna Angelo | Registered Nurse | 457 Spring Lane, Philadelphia, PA 19128 | 2016-05-13 |
| 1689049843 | Newcourtland Senior Centers | Clinic/Center | 4200b Mitchell Street, Suie 1000, Philadelphia, PA 19128 | 2015-12-14 |
| 1235519331 | Merin Wexler | Social Worker | 6060 Ridge Avenue, Suite 210, Philadelphia, PA 19128 | 2015-06-03 |
| 1457754335 | Sarah De Simone | Specialist/Technologist | 318 Fountain Street, Philadelphia, PA 19128 | 2014-10-06 |
| 1609280049 | Sylvia Russianoff | Counselor | 128 Rochelle Avenue, Philadelphia, PA 19128 | 2014-06-13 |
| Find all providers in zip 19128 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356940183 | Kenccid | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9350 Ashton Rd Rm 202, Philadelphia, PA 19114-7402 | 2020-10-22 |
| 1518425669 | Marthas Way | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1319 Mcferran St, Philadelphia, PA 19140-2005 | 2019-03-07 |
| 1457819690 | Personal Touch Professional Services II | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6603 N Gratz St, Philadelphia, PA 19126-2633 | 2019-03-06 |
| 1427531698 | Penn-jersey Integrated Human Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6272 Kindred St, Philadelphia, PA 19149-2805 | 2018-09-12 |
| 1114425691 | Norvetta Naomi Victoria Steward | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1524 N Gratz St, Philadelphia, PA 19121-4125 | 2018-01-30 |
| 1700240496 | Mega Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2704 S 86th St, Philadelphia, PA 19153-1501 | 2016-04-08 |
| 1770947533 | Mega Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2707 S 86th St, Philadelphia, PA 19153 | 2016-04-07 |
| 1518320373 | Providence Corporation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7928 Ridge Ave, First Floor, Philadelphia, PA 19128-3011 | 2016-03-30 |
| 1043671712 | Pius Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1333 S 49th St, Philadelphia, PA 19143-4442 | 2016-03-09 |
| 1013372184 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6600 Leeds St, Philadelphia, PA 19151-3028 | 2015-12-16 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19128 |
Please comment or provide details below to improve the information on DIVINE PROVIDENCE VILLAGE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.