DIVINE PROVIDENCE VILLAGE (NPI# 1811352701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811352701 |
| Entity Type | Organization |
| Organization Name | DIVINE PROVIDENCE VILLAGE |
| Practice Address |
41 Media Line Rd Apt. A-2 Broomall PA 19008-1246 |
| Mailing Address |
686 Old Marple Rd Springfield PA 19064-1239 |
| Practice Telephone | 6105433380 |
| Mailing Telephone | 6103287730 |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2015-12-21 |
| 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 | Residential Treatment Facilities |
| 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 |
| 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 |
| 1932564002 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 244 Kent Rd, Upper Darby, PA 19082-4205 | 2015-12-16 |
| Street Address |
41 MEDIA LINE RD APT. A-2 |
| City | BROOMALL |
| State | PA |
| Zip Code | 19008-1246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275098964 | Ashley Szewczuk | Occupational Therapy Assistant | 50 Malin Rd., Broomall, PA 19008 | 2019-02-06 |
| 1134647316 | Bernadette Jacobs | Registered Nurse | Accucare Home Nursing 1999 Sproul Rd, # 1, Broomall, PA 19008 | 2017-09-07 |
| 1447780549 | Laura Ann Jamison | Physical Therapy Assistant | 50 North Malin Road, Broomall, PA 19008 | 2017-06-13 |
| 1528596608 | Lauren S. Burns | Occupational Therapist | 51 N Malin Rd., Broomall, PA 19008 | 2017-06-01 |
| 1558893024 | Marc Belitsky D.c., .pc. | Clinic/Center | 2633 West Chester Pike, Broomall, PA 19008 | 2017-04-03 |
| 1053773390 | Helen Richman | Pharmacist | 567 Sproul Road, Broomall, PA 19008 | 2016-03-25 |
| 1487028007 | Jenelle Thomas | Social Worker | 85 N. Malin Road, Broomall, PA 19008 | 2015-11-19 |
| 1649654740 | Akeesha M Washington | Counselor | 600 Abbott Drive, Broomall, PA 19008 | 2015-07-17 |
| 1821411976 | Ketrin Kapllani | Behavioral Analyst | 475 Lawrence, Philadelphia, PA 19008 | 2014-01-27 |
| 1710325741 | Joel Christopher Fusunyan-lee | Registered Nurse | 219 Sussex Blvd, Broomall, PA 19008 | 2013-06-12 |
| Find all providers in zip 19008 | ||||
| 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 |
|---|---|---|---|---|
| 1699130237 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19 James Rd, Broomall, PA 19008-1409 | 2015-12-28 |
| 1982011367 | Acute Community Home Aid Achd Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 501 Abbott Drive 1st Floor Suite 2, Broomall, PA 19008-4320 | 2014-07-17 |
| 1801919915 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2603 Springfield Rd, Broomall, PA 19008-2133 | 2007-04-06 |
| 1952420697 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 99 S Sproul Rd, Broomall, PA 19008-2334 | 2007-03-27 |
| 1407973647 | Communities of Don Guanella and Divine Providence | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 727 Hedgerow Dr, Broomall, PA 19008-2729 | 2007-03-23 |
| 1790802031 | Communities of Don Guanella and Divine Providence | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2213 Glenspring Ln, Broomall, PA 19008-2222 | 2007-03-23 |
| 1114044112 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 105 4th Ave, Broomall, PA 19008-2321 | 2007-03-23 |
| 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 |
| 1952908618 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 604 Glen Circle Dr, Tobyhanna, PA 18466-8300 | 2020-10-06 |
| 1598375305 | Impactful Human Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1055 Westlakes Dr Ste 3003, Berwyn, PA 19312-2410 | 2020-08-06 |
| 1356969679 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 100 Genuardi Circle, West Chester, PA 19380 | 2020-07-13 |
| 1437775442 | The Arc of Crawford County, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 222 Chestnut St, Meadville, PA 16335-3407 | 2020-06-25 |
| 1568094142 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1768 Mcdonough Ave, Scranton, PA 18508-1566 | 2020-02-11 |
| 1114559267 | Keystone Community Resources, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 336 Sheridan Ave, Clarks Summit, PA 18411-1458 | 2020-02-06 |
| 1619507332 | Above & Beyond Berks LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1007 Saylor Dr, Temple, PA 19560-9587 | 2020-01-22 |
| 1700425287 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 639 N South Turnpike Rd, Newfoundland, PA 18445-5032 | 2019-12-31 |
| 1891331120 | Gifted Hands Home Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1853 William Penn Way Ste 13, Lancaster, PA 17601-6713 | 2019-11-21 |
| Find all providers with the same taxonomy | ||||
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| 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.