DIVINE PROVIDENCE VILLAGE (NPI# 1811362635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811362635 |
| Entity Type | Organization |
| Organization Name | DIVINE PROVIDENCE VILLAGE |
| Practice Address |
1313 Adair Rd Brookhaven PA 19015-1901 |
| Mailing Address |
686 Old Marple Rd Springfield PA 19064-1239 |
| Practice Telephone | 6105433380 |
| Mailing Telephone | 6103287730 |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2015-12-04 |
| 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 |
| 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 |
1313 ADAIR RD |
| City | BROOKHAVEN |
| State | PA |
| Zip Code | 19015-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487262614 | Hometown Rx Services | Pharmacy | 3406 Edgmont Avenue, Suite B, Brookhaven, PA 19015 | 2020-07-14 |
| 1932650926 | Giant Food Stores LLC | Durable Medical Equipment & Medical Supplies | 4930 Edgemont Ave, Brookhaven, PA 19015 | 2016-10-14 |
| 1982009254 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 225 Upland Road, Brookhaven, PA 19015 | 2014-10-29 |
| 1790959633 | Darlene M Longstreth | Massage Therapist | 3766 Susan Lane, Kinderssage, Brookhaven, PA 19015 | 2008-04-22 |
| 1538205463 | Scott Thomas Steltz | Pharmacist | 601 Upland Ave Suite 112, Steltec Pharmacy - Crozier Mills Enterprise Center, Upland, PA 19015 | 2007-01-29 |
| 1083769327 | Parkside Fire Company | Ambulance | 107 West Roland, Parkside, PA 19015 | 2007-01-25 |
| 1295894699 | Elizabeth Katherine Deegan | Counselor | 4928 Shepard St., Brookhaven, PA 19015 | 2006-12-08 |
| 1013093244 | Jeffrey Keith Rosen | Family Medicine | 100 East Brookhaven Rd, Brookhaven, PA 19015 | 2006-10-31 |
| 1013015726 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 3298 Edgemont Ave, Brookhaven, PA 19015 | 2006-09-20 |
| 1285743187 | Micheal A Erbicella | Dentist | 3213 Edgmont Ave, Brookhaven, PA 19015 | 2006-08-30 |
| Find all providers in zip 19015 | ||||
| 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 |
| 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 | ||||
| City | BROOKHAVEN |
| Zip Code | 19015 |
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.